Clinical Benefits of Facial Nerve Monitoring during Cerebellopontine Angle Surgery

Farag, Ahmed A.; Ibrahim, Abd El-Kafy Sharaf El-Din; Alaghory, Islam M.

doi:10.4236/ojmn.2022.121002

Cited by 1 publication

(1 citation statement)

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“…Falcioni et al have reported that among 1052 patients with anatomically preserved FNs and total tumor removal, 65% demonstrated postoperative HB Grade I or II, 29.4% had grade III, and 5.6% presented unsatisfactory results (HB grades IV–VI) [ 115 ]. A prospective study involving 30 patients showed that excellent facial nerve function (HB grade I and II) was higher in a group of patients operated under continuous intraoperative facial nerve monitoring (IOFNM) than in a group of patients who underwent CPA tumor excision without IONFNM, immediately and at 6 months post-operation (80% and 93% vs. 53.3% and 66.7%) [ 116 ]. Since the resection of skull base tumors, such as glomus tumor jugulare, neuromas of cranial nerves IX–XI, infralabyrinthine cholesteatomas, mesenchymal tumors, and meningiomas, is limited by the intratemporal course of the facial nerve, numerous techniques of facial nerve rerouting have been developed [ 117 ].…”

Section: Resultsmentioning

confidence: 99%

A Comprehensive Approach to Facial Reanimation: A Systematic Review

Pinkiewicz

Dorobisz

Zatoński

2022

JCM

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Purpose: To create a systematic overview of the available reconstructive techniques, facial nerve grading scales, physical evaluation, the reversibility of paralysis, non-reconstructive procedures and medical therapy, physical therapy, the psychological aspect of facial paralysis, and the prevention of facial nerve injury in order to elucidate the gaps in the knowledge and discuss potential research aims in this area. A further aim was to propose an algorithm simplifying the selection of reconstructive strategies, given the variety of available reconstructive methods and the abundance of factors influencing the selection. Methodological approach: A total of 2439 papers were retrieved from the Medline/Pubmed and Cochrane databases and Google Scholar. Additional research added 21 articles. The primary selection had no limitations regarding the publication date. We considered only papers written in English. Single-case reports were excluded. Screening for duplicates and their removal resulted in a total of 1980 articles. Subsequently, we excluded 778 articles due to the language and study design. The titles or abstracts of 1068 articles were screened, and 134 papers not meeting any exclusion criterion were obtained. After a full-text evaluation, we excluded 15 papers due to the lack of information on preoperative facial nerve function and the follow-up period. This led to the inclusion of 119 articles. Conclusions: A thorough clinical examination supported by advanced imaging modalities and electromyographic examination provides sufficient information to determine the cause of facial palsy. Considering the abundance of facial nerve grading scales, there is an evident need for clear guidelines regarding which scale is recommended, as well as when the postoperative evaluation should be carried out. Static procedures allow the restoral of facial symmetry at rest, whereas dynamic reanimation aims to restore facial movement. The modern approach to facial paralysis involves neurotization procedures (nerve transfers and cross-facial nerve grafts), muscle transpositions, and microsurgical free muscle transfers. Rehabilitation provides patients with the possibility of effectively controlling their symptoms and improving their facial function, even in cases of longstanding paresis. Considering the mental health problems and significant social impediments, more attention should be devoted to the role of psychological interventions. Given that each technique has its advantages and pitfalls, the selection of the treatment approach should be individualized in the case of each patient.

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Section: Resultsmentioning

confidence: 99%