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Babuci A, Palarie V, Catereniuc I, Zorina Z, Visnevschi S, Heimes D, Lehtman S, Kämmerer PW. Variability of the Cervical Branch Depending on the Facial Nerve Branching Pattern and Anthropometric Type of the Head. Neurol Int 2024; 16:113-125. [PMID: 38251055 PMCID: PMC10801503 DOI: 10.3390/neurolint16010007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/25/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
(1) Background: Considering that the specialty literature supplies only general data about the variability of the cervical branch of the facial nerve, this study aimed to determine this branch's variation and individual peculiarities depending on the nerve branching pattern and anthropometric type of the head. (2) Methods: The study was conducted on 75 hemifaces of adult formalized cadavers. Ahead of anatomical dissection, each head was measured to establish the anthropometric type, according to Franco and colleagues. The branching patterns were then distributed according to the Davis classification. (3) Results: The number of cervical branches (CB) of the facial nerve varied from one to five branches, with the following rate: 1 CB (61.3%), 2 CB (28%), 3 CB (6.7%), 4 CB (2.7%), and 5 CB (1.3%). Seven branching patterns of the facial nerve were revealed: Type I in 18.7%, Type II in 14.7%, Type III in 20%, Type IV in 14.6%, Type V in 5.3%, Type VI in 18.7%, and Type NI in 8% (bizarre types). According to the branching pattern, the mean numbers of the cervical branches were as follows: Type I-1.6 ± 1.02; Type II-1.4 ± 0.50; Type III-1.4 ± 0.50; Type IV-1.4 ± 0.67; Type V-2.0 ± 1.41; Type VI-1.8 ± 1.12; and Type-NI-1.8 ± 0.75; p = 0.599. According to the anthropometric type of the head, the mean number of CB in the mesocephalic type (MCT) was 1.5 ± 0.82, in the dolichocephalic type (DCT), 1.7 ± 0.87, and in the brachycephalic type, (BCT) 1.8 ± 1.04; p = 0.668. (4) Conclusions: The cervical branch of the facial nerve varies depending on the facial nerve branching pattern and the anthropometric type of the head. The highest degree of variation was characteristic of BCT and Type V and the lowest, of MCT and Types II, III, and IV.
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Affiliation(s)
- Angela Babuci
- Department of Anatomy and Clinical Anatomy, Nicolae Testemitanu State University of Medicine and Pharmacy, 2004 Chișinău, Moldova; (A.B.); (V.P.); (I.C.); (Z.Z.); (S.V.)
| | - Victor Palarie
- Department of Anatomy and Clinical Anatomy, Nicolae Testemitanu State University of Medicine and Pharmacy, 2004 Chișinău, Moldova; (A.B.); (V.P.); (I.C.); (Z.Z.); (S.V.)
| | - Ilia Catereniuc
- Department of Anatomy and Clinical Anatomy, Nicolae Testemitanu State University of Medicine and Pharmacy, 2004 Chișinău, Moldova; (A.B.); (V.P.); (I.C.); (Z.Z.); (S.V.)
| | - Zinovia Zorina
- Department of Anatomy and Clinical Anatomy, Nicolae Testemitanu State University of Medicine and Pharmacy, 2004 Chișinău, Moldova; (A.B.); (V.P.); (I.C.); (Z.Z.); (S.V.)
| | - Sergiu Visnevschi
- Department of Anatomy and Clinical Anatomy, Nicolae Testemitanu State University of Medicine and Pharmacy, 2004 Chișinău, Moldova; (A.B.); (V.P.); (I.C.); (Z.Z.); (S.V.)
| | - Diana Heimes
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, 55131 Mainz, Germany;
| | - Sofia Lehtman
- Department of Oral and Maxillofacial Surgery and Oral Implantology, Nicolae Testemitanu State University of Medicine and Pharmacy, 2004 Chișinău, Moldova;
| | - Peer W. Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, 55131 Mainz, Germany;
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A modified method for minimizing damage to the marginal mandibular branch (MMB) during partial superficial parotidectomy(PSP): A retrospective study. J Craniomaxillofac Surg 2022; 50:637-642. [DOI: 10.1016/j.jcms.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/23/2022] [Accepted: 07/12/2022] [Indexed: 11/18/2022] Open
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Charoenlux P, Utoomprurkporn N, Seresirikachorn K. The efficacy of corticosteroid after facial nerve neurorrhaphy: a systematic review and meta-analysis of randomized controlled trial. Braz J Otorhinolaryngol 2021; 89:79-89. [PMID: 34815200 PMCID: PMC9874359 DOI: 10.1016/j.bjorl.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/26/2021] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES The benefit of corticosteroids following facial nerve neurorrhaphy in the setting of complete transection is questionable. This systematic review and meta-analysis aimed to evaluate corticosteroid efficacy on facial nerve regeneration and functional recovery after complete disruption and neurorrhaphy. METHODS Randomized controlled trials on both human and animal models from Ovid MEDLINE and Ovid EMBASE studying corticosteroid efficacy in complete facial nerve disruption followed by neurorrhaphy were included. Data were extracted and pooled for meta-analysis. The outcomes were evaluated from electrophysiology, histology, and functional recovery. However, no randomized controlled trial in human was performed. Possibly, performing human trials with histopathology may not be feasible in clinical setting. RESULTS Six animal studies (248 participants) met inclusion criteria. Electrophysiologic outcomes revealed no differences in latency (Standardized Mean Difference (SMD) = -1.97, 95% CI -7.38 to 3.44, p = 0.47) and amplitude (SMD = 0.37, 95% CI -0.44 to 1.18, p = 0.37) between systemic corticosteroids and controls. When analysis compared topical corticosteroid and control, the results provided no differences in latency (Mean Difference (MD) = 0.10, 95% CI -0.04 to 0.24, p = 0.16) and amplitude (SMD = 0.01, 95% CI -0.08 to 0.10, p = 0.81). In histologic outcomes, the results showed no differences in axon diameter (MD = 0.13, 95% CI -0.15 to 0.41, p = 0.37) between systemic corticosteroid and control; however, the result in myelin thickness (MD = 0.06, 95% CI 0.04 to 0.08, p < 0.05) favored control group. When comparing systemic corticosteroid with control in eye blinking, the results favored control (MD = 1.33, 95% CI 0.60 to 2.06, p = 0.0004). CONCLUSIONS This evidence did not show potential benefits of systemic or topical corticosteroid deliveries after facial nerve neurorrhaphy in complete transection when evaluating electrophysiologic, histologic, and functional recovery outcomes in animal models.
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Affiliation(s)
- Prapitphan Charoenlux
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nattawan Utoomprurkporn
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand,UCL Ear Institute, Faculty of Brain Science, University College London, London, United Kingdom
| | - Kachorn Seresirikachorn
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand,Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand,Corresponding author.
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Thielker J, Wahdan A, Buentzel J, Kaftan H, Boeger D, Mueller AH, Wittig A, Schultze-Mosgau S, Ernst T, Guntinas-Lichius O. Long-Term Facial Nerve Outcome in Primary Parotid Cancer Surgery: A Population-Based Analysis. Laryngoscope 2021; 131:2694-2700. [PMID: 34050959 DOI: 10.1002/lary.29666] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/18/2021] [Accepted: 05/22/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVES/HYPOTHESIS To determine immediate postoperative and long-term facial nerve dysfunction after parotid cancer surgery, risk factors, and the role of facial reanimation surgery. STUDY DESIGN Population-based long-term analysis for all new primary parotid carcinoma cases in Thuringia from 1996 to 2019. METHODS Data of the cancer registries of Thuringia, a federal state in Germany, were analyzed in combination with hospital-based data on facial function. RESULTS About 477 patients (42.3% women; median age: 68 years) were included. It was observed that 6.7% had a preoperative facial nerve dysfunction, 11.7% received a radical parotidectomy, that is, that 5% had a normal preoperative facial function but needed radical surgery because of intraoperative detection of tumor infiltration into the facial nerve. About 10.2% received facial nerve reconstruction surgery. Immediate postoperative facial nerve dysfunction in the other patients was observed in 34.4% of the patients. Advanced T classification (odds ratio [OR] = 2.140; confidence interval [CI] = 1.268-3.611; P = .004) and neck dissection (OR = 2.012; CI = 1.027-3.940; P = .041) were independent risk factors for immediate postoperative facial nerve dysfunction. In addition, 22.0% showed no recovery during follow-up. Advanced T classification (OR = 2.177; CI = 1.147-4.133; P = .017) and postoperative radiotherapy (OR = 2.695; CI = 1.244-5.841; P = .012) were independent risk factors for permanent postoperative facial nerve dysfunction. CONCLUSION Patients with primary parotid cancer are at high risk for long-term facial nerve dysfunction. It seems that the possibilities of facial reanimation surgery needs to be utilized even more effectively. LEVEL OF EVIDENCE 3 Laryngoscope, 2021.
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Affiliation(s)
- Jovanna Thielker
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany.,Facial Nerve Center Jena, Jena University Hospital, Jena, Germany
| | - Ali Wahdan
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - Jens Buentzel
- Department of Otorhinolaryngology, Suedharzklinikum Nordhausen, Nordhausen, Germany
| | - Holger Kaftan
- Department of Otorhinolaryngology, Helios-Klinikum Erfurt, Erfurt, Germany
| | - Daniel Boeger
- Department of Otorhinolaryngology, SRH Zentralklinikum Suhl, Suhl, Germany
| | - Andreas H Mueller
- Department of Otorhinolaryngology, SRH Wald-Klinikum Gera, Gera, Germany
| | - Andrea Wittig
- Department of Radiotherapy and Radiation Oncology, Jena University Hospital, Jena, Germany
| | - Stefan Schultze-Mosgau
- Department of Oromaxillofacial Surgery and Plastic Surgery, Jena University Hospital, Jena, Germany
| | - Thomas Ernst
- University Tumor Center, Jena University Hospital, Jena, Germany
| | - Orlando Guntinas-Lichius
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany.,Facial Nerve Center Jena, Jena University Hospital, Jena, Germany
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Ning Y, Wang W, Cai Y, Zhou Y, Jiang J, Zeng D, Sun R, Wang X, Zheng W, He T, Shui C, Liu W, Zhang Y, Chen X, Li C. The application of venous nerve conduit trap in the immediate repair and reconstruction of facial nerve in parotid gland tumor: an attempt of a new technique. Eur Arch Otorhinolaryngol 2021; 278:4967-4976. [PMID: 33948682 DOI: 10.1007/s00405-021-06732-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/09/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To introduce the application of venous nerve conduit in the immediate repair and reconstruction of facial nerve in parotid gland tumor. METHODS Three patients with parotid gland tumor in Sichuan Provincial Cancer Hospital were reviewed. All patients were found that the tumor encased and invaded the facial nerve which was difficult to be separated during the operation when all patients were treated with facial nerve repair and reconstruction with the venous nerve conduit trapping technique. RESULTS After 1-year follow-up, all patients recovered well in facial nerve function. CONCLUSION The venous nerve conduit trapping technique is an effective attempt in the immediate repair and reconstruction of facial nerve in parotid gland tumor, but it needs to be further confirmed by multiple studies.
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Affiliation(s)
- Yudong Ning
- Department of Head and Neck Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology, Chengdu, China
| | - Wei Wang
- Department of Head and Neck Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology, Chengdu, China
| | - Yongcong Cai
- Department of Head and Neck Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology, Chengdu, China
| | - Yuqiu Zhou
- Department of Head and Neck Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology, Chengdu, China
| | - Jian Jiang
- Department of Head and Neck Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology, Chengdu, China
| | - Dingfen Zeng
- Department of Head and Neck Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology, Chengdu, China
| | - Ronghao Sun
- Department of Head and Neck Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology, Chengdu, China
| | - Xu Wang
- Department of Head and Neck Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology, Chengdu, China
| | - Wanghu Zheng
- Department of Head and Neck Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology, Chengdu, China
| | - Tianqi He
- Department of Head and Neck Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology, Chengdu, China
| | - Chunyan Shui
- Department of Head and Neck Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology, Chengdu, China
| | - Wei Liu
- Department of Head and Neck Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology, Chengdu, China
| | - Yuyao Zhang
- Department of Head and Neck Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology, Chengdu, China
| | - Xiaolei Chen
- Department of Head and Neck Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology, Chengdu, China
| | - Chao Li
- Department of Head and Neck Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology, Chengdu, China. .,Department of Head and Neck Surgery, Sichuan Cancer Hospital, No.55, 4th Section of Southern Renmin Road, Chengdu, 610041, Sichuan, China.
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Immediate compared with late repair of extracranial branches of the facial nerve: a comparative study. Br J Oral Maxillofac Surg 2020; 58:163-169. [DOI: 10.1016/j.bjoms.2019.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 11/05/2019] [Indexed: 11/23/2022]
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Costa MGESTD, Maranhão-Filho PDA, Santos IC, Luiz RR, Vincent MB. Parotidectomy-related facial nerve lesions: proposal for a modified Sunnybrook Facial Grading System. ARQUIVOS DE NEURO-PSIQUIATRIA 2019; 77:460-469. [PMID: 31365637 DOI: 10.1590/0004-282x20190074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 03/24/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Facial nerve injury, affecting mainly the marginal mandibular branch, is the most frequent neurologic complication from parotidectomy. To test a modified Sunnybrook Facial Grading System as a new tool to assess the facial nerve function following parotidectomy, emphasizing the marginal mandibular branch. METHODS We reviewed the medical records of 73 post-parotidectomy patients (40 female, 18-84 years old, mean age 53.2 years) with facial nerve sparing, referred to the Department of Physical Therapy. All patients had parotid neoplasms or advanced skin cancer, and were followed by the principal author between 2006 and 2014. RESULTS The muscles innervated by the marginal mandibular branch were the most frequently affected (72.6%), particularly in patients undergoing neck dissection (p = 0.023). The voluntary movement scores obtained with the modified system were significantly lower compared with the original version (p < 0.001). The best and worst scores were observed in patients with benign parotid tumors and skin cancer, respectively. Patients requiring neck dissection (p = 0.031) and resection of other structures (p = 0.021) had the lowest scores, evidenced only with the modified version. Patients with malignant tumors had significantly worse ratings, regardless of the Sunnybrook system version. The post-physiotherapy analysis involved 50 patients. The worst facial rehabilitation outcomes were related to the marginal mandibular branch function. CONCLUSION The modified Sunnybrook Facial Grading System improved the marginal mandibular branch assessment, preserving the evaluation of other facial nerve branches.
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Affiliation(s)
| | | | - Izabella Costa Santos
- Instituto Nacional de Câncer, Serviço de Cirurgia de Cabeça e Pescoço, Rio de Janeiro RJ, Brasil
| | - Ronir Raggio Luiz
- Universidade Federal do Rio de Janeiro, Instituto de Estudos de Saúde Pública, Rio de Janeiro RJ, Brasil
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