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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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Bubeníková A, Vlasák A, Fík Z, Sedlák V, Tesařová M, Bradáč O. Application of diffusion tensor imaging of the facial nerve in preoperative planning for large vestibular schwannoma: a systematic review. Neurosurg Rev 2023; 46:298. [PMID: 37950058 DOI: 10.1007/s10143-023-02214-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/28/2023] [Accepted: 11/05/2023] [Indexed: 11/12/2023]
Abstract
The accurate identification and preservation of the facial nerve (FN) during vestibular schwannoma (VS) surgery is crucial for maintaining facial function. Investigating the application of diffusion tensor imaging (DTI) in preoperative planning for large VS surgery is provided. PubMed, Cochrane Library, Science Direct, ISI Web of Science, Embase, and additional sources were searched to identify cohort studies about the preoperative DTI usage for the FN tracking before large VS (≥ 2.5 cm) surgery published between 1990 and 2023. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed; the Newcastle-Ottawa Scale was used to assess the risk of bias and to evaluate limitations based on selection/outcome biases. A total of 8 publications yielding 149 VS (mean size 3.66 ± 0.81 cm) were included. Surgical concordance with preoperative DTI FN tracking was 91.67% (range 85-100%). Overall DTI reliability was 88.89% (range 81.81-95.83%). Larger tumor size predicted either DTI inaccurate finding or complete DTI failure (p = 0.001). VS size above > 3.5 cm was associated with a higher risk of DTI failure (p = 0.022), with a higher risk of inaccurate DTI finding preoperatively (p = 0.033), and with a higher House-Brackman score postoperatively (p = 0.007). Application of DTI in larger VS surgery is a valuable FN identification along with electrophysiological monitoring and neuronavigation, therefore also in its preservation and in lowering risk of complications. DTI represents a valuable adjunct to electrophysiological monitoring and neuronavigation in FN identification, applicable not only for smaller, but also larger VS.
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Affiliation(s)
- Adéla Bubeníková
- Department of Neurosurgery, 2nd Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, 150 06 Prague 5, Prague, Czech Republic
- Department of Neurosurgery and Neurooncology, 1st Faculty of Medicine, Charles University and Military University Hospital, Prague, Czech Republic
| | - Aleš Vlasák
- Department of Neurosurgery, 2nd Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, 150 06 Prague 5, Prague, Czech Republic.
| | - Zdeněk Fík
- Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Vojtěch Sedlák
- Department of Radiology, Military University Hospital, Prague, Czech Republic
| | - Michaela Tesařová
- Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Ondřej Bradáč
- Department of Neurosurgery, 2nd Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, 150 06 Prague 5, Prague, Czech Republic
- Department of Neurosurgery and Neurooncology, 1st Faculty of Medicine, Charles University and Military University Hospital, Prague, Czech Republic
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Wu X, Ou S, Zhang H, Zhen Y, Huang Y, Wei P, Shan Y. Long-term follow-up seizure outcomes after corpus callosotomy: A systematic review with meta-analysis. Brain Behav 2023; 13:e2964. [PMID: 36929636 PMCID: PMC10097058 DOI: 10.1002/brb3.2964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Corpus callosotomy (CC) is appropriate for patients with seizures of a bilateral or diffuse origin, or those with seizures of a unilateral origin with rapid spread to the contralateral cerebral hemisphere. The efficiency of CC in patients with drug-resistant epilepsy is a long-term concern because most articles reporting the surgical results of CC arise from small case series, and the durations of follow-up vary. METHODS PubMed, Embase, Cochrane Library, and Web of Science were searched to identify papers published before November 8, 2021. The systematic review was completed following PRISMA guidelines. Outcomes were analyzed by meta-analysis of the proportions. RESULTS A total of 1644 patients with drug-resistant epilepsy (49 retrospective or prospective case series studies) underwent CC, and the follow-up time of all patients was at least 1 year. The rate of complete seizure freedom (SF) was 12.38% (95% confidence interval [CI], 8.17%-17.21%). Meanwhile, the rate of complete SF from drop attacks was 61.86% (95% CI, 51.87%-71.41%). The rates of complete SF after total corpus callosotomy (TCC) and anterior corpus callosotomy (ACC) were 11.41% (95% CI, 5.33%-18.91%) and 6.75% (95% CI, 2.76%-11.85%), respectively. Additionally, the rate of complete SF from drop attacks after TCC was significantly higher than that after ACC (71.52%, 95% CI, 54.22%-86.35% vs. 57.11%, 95% CI, 42.17%-71.49%). The quality of evidence for the three outcomes by GRADE assessment was low to moderate. CONCLUSION There was no significant difference in the rate of complete SF between TCC and ACC. TCC had a significantly higher rate of complete SF from drop attacks than did ACC. Furthermore, CC for the treatment of drug-resistant epilepsy remains an important problem for further investigation because there are no universally accepted standardized guidelines for the extent of CC and its benefit to patients. In future research, we will focus on this issue.
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Affiliation(s)
- Xiaolong Wu
- Department of Neurosurgery, XuanWu Hospital, Capital Medical University, Beijing, China.,International Neuroscience Institute (China-INI), Beijing, China.,Clinical Research Center for Epilepsy, Capital Medical University, Beijing, China
| | - Siqi Ou
- Department of Neurosurgery, XuanWu Hospital, Capital Medical University, Beijing, China.,International Neuroscience Institute (China-INI), Beijing, China.,Clinical Research Center for Epilepsy, Capital Medical University, Beijing, China
| | - Huaqiang Zhang
- Department of Neurosurgery, XuanWu Hospital, Capital Medical University, Beijing, China.,International Neuroscience Institute (China-INI), Beijing, China.,Clinical Research Center for Epilepsy, Capital Medical University, Beijing, China
| | - Yuhang Zhen
- Department of Neurosurgery, XuanWu Hospital, Capital Medical University, Beijing, China.,International Neuroscience Institute (China-INI), Beijing, China.,Clinical Research Center for Epilepsy, Capital Medical University, Beijing, China
| | - Yinchun Huang
- Department of Neurosurgery, XuanWu Hospital, Capital Medical University, Beijing, China.,International Neuroscience Institute (China-INI), Beijing, China.,Clinical Research Center for Epilepsy, Capital Medical University, Beijing, China
| | - Penghu Wei
- Department of Neurosurgery, XuanWu Hospital, Capital Medical University, Beijing, China.,International Neuroscience Institute (China-INI), Beijing, China.,Clinical Research Center for Epilepsy, Capital Medical University, Beijing, China
| | - Yongzhi Shan
- Department of Neurosurgery, XuanWu Hospital, Capital Medical University, Beijing, China.,International Neuroscience Institute (China-INI), Beijing, China.,Clinical Research Center for Epilepsy, Capital Medical University, Beijing, China
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