Intraoperative monitoring of marginal mandibular nerve during neck dissection

Tirelli, Gian Carlo; Bergamini, Pier Riccardo; Scardoni, A; Gatto, Annalisa; Nata, Francesca Boscolo; Marcuzzo, Alberto Vito

doi:10.1002/hed.25078

Cited by 15 publications

(14 citation statements)

References 44 publications

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“…Another possible use of IONM is the prevention of marginal mandibular nerve injury during neck dissection in cases where a level I B dissection and thorough clean-up is required [ 22 ].…”

Section: Resultsmentioning

confidence: 99%

“…The other nerves (i.e., hypoglossal nerve, brachial plexus and phrenic nerve) are rarely the site of injuries, and their identification is facilitated by the anatomical respect of the deep cervical fascia. In the rare case of necessity of level 1b dissection, IONM may be useful to avoid injury to the marginal branch of the facial nerve [ 22 ]. Transient and definitive hypocalcemia is another frequent complication of neck dissection.…”

Section: Discussionmentioning

confidence: 99%

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Surgical Skills and Technological Advancements to Avoid Complications in Lateral Neck Dissection for Differentiated Thyroid Cancer

Bove

Farrukh

Gioia

et al. 2021

Cancers

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Neck dissection is a surgical procedure reserved for thyroid cancer cases with clinically evident lymphatic invasion. Although neck dissection is a reliable and safe procedure, it can determine a significant morbidity involving a variety of structures of nervous, vascular and endocrine typology. A careful pre-operative study is therefore essential to better plan surgery. Surgical experience, combined with accurate surgical preparation and merged with adequate and specific techniques, can certainly help reduce the percentage of complications. In recent years, however, technology has also proved to be useful. Its crucial role was already recognized in the safeguard of the integrity of the laryngeal nerve through neuro-monitoring, but new technologies are emerging to help the preservation also of the parathyroid glands and other structures, such as the thoracic duct. These surgical skills combined with the latest technological advancements, that allow us to reduce the incidence of complications after neck dissection for thyroid cancer, will be reported in the present article. This topic is of significant interest for the endocrine and metabolic surgeons’ community.

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“…Another possible use of IONM is the prevention of marginal mandibular nerve injury during neck dissection in cases where a level I B dissection and thorough clean-up is required [ 22 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Surgical Skills and Technological Advancements to Avoid Complications in Lateral Neck Dissection for Differentiated Thyroid Cancer

Bove

Farrukh

Gioia

et al. 2021

Cancers

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“…Among them, the study of Strantzias et al traced the course of the marginal nerve, an anatomical structure for which it is difficult to find safe anatomical landmarks. 17,28,29 One limitation of this study is the small number of patients enrolled. Future studies with larger patient populations will make it possible to better establish the accuracy of the Anatomage Table in evaluating capsular involvement, especially in the MiN group.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of the Anatomage Table in detecting extranodal extension in head and neck cancer: a pilot study

et al. 2021

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Purpose: To assess whether the three-dimensional reconstructions of preoperative computed tomography (CT) scans are helpful for establishing extranodal extension (ENE) in head and neck carcinoma.Approach: Patients with a histological diagnosis of ENE (pENEþ) were considered "cases" and patients with negative histological examination for ENE (pENE−) were considered "controls." Cases and controls were divided into two groups: a major nodes (MaN) group (lymph nodes on CT > 15 mm) and a minor nodes (MiN) group (lymph nodes on CT ≤ 15 mm). The preoperative CT scans were uploaded to the Anatomage Table and were randomly and blindly provided to the radiologist for assessment. The findings at the Anatomage Table were compared with those of CT and magnetic resonance imaging (MRI) scans.Results: Analysis of data from the MaN group showed that the Anatomage Table had a higher percentage of concordance with histopathological examination (90%) than the CT and MRI scans. The Anatomage Table had 100% sensitivity in identifying all pENEþ patients, associated with a lower specificity. The negative predictive value of 100% allowed identification of pENE− patients. In the MiN group, on the other hand, sensitivity was lower, related to a high number of false-negative results.Conclusions: The Anatomage Table could represent a useful tool for preoperatively establishing the extranodal extension of cervical lymph node metastasis.

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“…A common instance for MMN palsy is during surgical approaches to submandibular region [12,[22][23][24][25][26][27][28]. The MMN is more often jointly found with perifacial lymph nodes in the submandibular triangle (Fig.…”

Section: Relation To Perifacial Lymph Nodesmentioning

confidence: 99%

Marginal mandibular nerve — a wandering enigma and ways to tackle it

Kudva

Babu

Saha

et al. 2021

Egypt J Otolaryngol

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Background This study aims to propose surgical approaches intended to localize and preserve the marginal mandibular nerve (MMN) during routinely performed head and neck surgical procedures. Main body of abstract Preservation of the functional integrity of the MMN is a critical measure in the success of orofacial surgeries involving the submandibular triangle. This study systematically reviews the anatomical description of the nerve including origin, course relative to fascial planes, relation to the parotid gland and facial pedicle, branching pattern and anastomosis of nerve and consolidate the findings of several significant studies to determine the “surgically safe” approaches to avoid iatrogenic injury to MMN. Short conclusion The systematic approaches described in this study have helped the authors precisely determine which particular MMN preserving approach to be adopted for each aspect of head and neck surgery. This has definitely enhanced the quality of surgery performed and the postoperative satisfaction of the patients.

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Intraoperative monitoring of marginal mandibular nerve during neck dissection

Abstract: In our opinion, NIM is a valuable aid for preventing marginal mandibular nerve injuries during neck dissection.

Cited by 15 publications

References 44 publications

Surgical Skills and Technological Advancements to Avoid Complications in Lateral Neck Dissection for Differentiated Thyroid Cancer

Surgical Skills and Technological Advancements to Avoid Complications in Lateral Neck Dissection for Differentiated Thyroid Cancer

Accuracy of the Anatomage Table in detecting extranodal extension in head and neck cancer: a pilot study

Marginal mandibular nerve — a wandering enigma and ways to tackle it

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