Preoperative Facial Nerve Mapping to Plan and Guide Pediatric Facial Vascular Anomaly Resection

Bly, Randall A.; Holdefer, Robert N.; Slimp, Jefferson C.; Kinney, Gregory A.; Martı́nez, Vicente; Manning, Scott C.; Perkins, Jonathan A.

doi:10.1001/jamaoto.2018.0054

Cited by 22 publications

(8 citation statements)

References 12 publications

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“…Using short (duration = 250 μs), monophasic, rectangular single pulses, average stimulation intensities of about 4 mA were sufficient (minimum = 1 mA, when the branch was lying very superficial; maximum = 11 mA, when the branch was lying deep in the parotid gland) and allowed a painless and detailed FNM of a normal facial nerve. In comparison, in children with lymphatic malformation and under general anesthesia, similar stimulation parameters with 200‐μs‐duration pulses at a rate of 1 to 2 Hz and slightly higher stimulation intensities of 6 to 15 mA were needed to elicit motor responses of the mimic muscles . It is important to emphasize that the stimulation parameters used only allowed nerve stimulation but not direct muscle stimulation.…”

Section: Discussionmentioning

confidence: 99%

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Altered facial muscle innervation pattern in patients with postparetic facial synkinesis

2019

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Objectives/Hypothesis: Using surface electrostimulation, we aimed to use facial nerve mapping (FNM) in healthy subjects and patients with postparetic facial synkinesis (PPFS) to define functional facial target regions that can be stimulated selectively.Study Design: Single-center prospective cohort study. Methods: FNM was performed bilaterally in 20 healthy subjects and 20 patients with PPFS. Single-pulse surface FNM started at the main trunk of the facial nerve and followed the peripheral branches in a distal direction. Stimulation started with 0.1 mA and increased in 0.1 mA increments. The procedure was simultaneously video recorded and evaluated offline.Results: A total of 1,873 spots were stimulated, and 1,875 facial movements were evaluated. The stimulation threshold was higher on the PPFS side (average = 9.8 AE 1.0 mA) compared to the contralateral side (4.1 AE 0.8 mA) for all stimulation sites or compared to healthy subjects (4.1 AE 0.5 mA; all P < .01). In healthy subjects, selective electrostimulation AE one unintended coactivation was possible at all sites in >80% of cases, with the exception of pulling up the corner of the mouth (65%-75%). On the PPFS side, stimulation was possible for puckering lips movements in 60%/75% (selective stimulation AE one coactivation, respectively), blinking in 55%/80%, pulling up the corner of the mouth in 50%/85%, brow raising in 5%/85, and raising the chin in 0%/35% of patients, respectively.Conclusions: FNM mapping for surgical planning and selective electrostimulation of functional facial regions is possible even in patients with PPFS. FNM may be a tool for patient-specific evaluation and placement of electrodes to stimulate the correct nerve branches in future bionic devices (e.g., for a bionic eye blink).

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Section: Discussionmentioning

confidence: 99%

“…He used the technique to preoperatively visualize the entire course of the extratemporal facial nerve on the skin surface. Preoperative FNM is routinely performed by some groups to plan and guide surgery of facial vascular malformations …”

Section: Introductionmentioning

confidence: 99%

Altered facial muscle innervation pattern in patients with postparetic facial synkinesis

2019

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“…Park already developed the concept of FNM using transcutaneous electrostimulation in 1998 [48]. Nevertheless, as part of preoperative work-up FNM has so far mainly been established before surgery of vascular malformations [49]. FNM helps to map the course of the peripheral facial nerve and its fine peripheral branches in patients with tumor or scar around the facial nerve [50].…”

Section: Transcutaneous Facial Nerve Mapping (Fnm)mentioning

confidence: 99%

Facial nerve electrodiagnostics for patients with facial palsy: a clinical practice guideline

Guntinas‐Lichius

Volk

Olsen

et al. 2020

Eur Arch Otorhinolaryngol

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Purpose Facial nerve electrodiagnostics is a well-established and important tool for decision making in patients with facial nerve diseases. Nevertheless, many otorhinolaryngologist-head and neck surgeons do not routinely use facial nerve electrodiagnostics. This may be due to a current lack of agreement on methodology, interpretation, validity, and clinical application. Electrophysiological analyses of the facial nerve and the mimic muscles can assist in diagnosis, assess the lesion severity, and aid in decision making. With acute facial palsy, it is a valuable tool for predicting recovery. Methods This paper presents a guideline prepared by members of the International Head and Neck Scientific Group and of the Multidisciplinary Salivary Gland Society for use in cases of peripheral facial nerve disorders based on a systematic literature search. Results Required equipment, practical implementation, and interpretation of the results of facial nerve electrodiagnostics are presented. Conclusion The aim of this guideline is to inform all involved parties (i.e. otorhinolaryngologist-head and neck surgeons and other medical specialists, therapeutic professionals and the affected persons) and to provide practical recommendations for the diagnostic use of facial nerve electrodiagnostics.

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“…cases, excision is difficult because of the location of the LM, its poorly defined borders, and the potential for injury to adjacent structures. [2][3][4] Sclerotherapy provides an alternative treatment option. Picibanil demonstrated efficacy and acceptable safety for macrocystic LM treatment in 2 prospective randomized controlled trials.…”

Section: Figurementioning

confidence: 99%

Celecoxib as a Potential Treatment for Intractable Lymphatic Malformation

Imamura¹,

Okamoto

Nishikawa

et al. 2019

Pediatrics

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Lymphatic malformation (LM) is a congenital disorder resulting from an abnormal development of lymphatic vessels. LM may result in problems of cosmesis and functional impairment, including airway compression. An 11-year-old girl was referred to our department with increasing dysphagia caused by a large left cervical LM with a long history of treatment. Because of the LM location, surgical resection was not an option, and various therapies, including use of picibanil, had proven ineffective. Celecoxib treatment (100 mg/day) was initiated for local pain management. Softening of the lesion was observed 2 weeks after treatment initiation, and the dose was increased to 200 mg/day with additional shrinking of the LM over the next 2 weeks. With parental consent, celecoxib was continued, with a 65% reduction in volume achieved at 6 months. The patient discontinued treatment at 12 months, and the LM volume increased. Control over the LM was achieved with resumption of celecoxib treatment. After 2 years of treatment, the LM persists, but the size of the malformation is significantly smaller. No adverse effects of celecoxib treatment were observed. The anti–cyclooxygenase-2 effect of celecoxib prevented lymphatic vessel growth through an inhibition of cyclooxygenase-2 activity in the conversion of prostaglandin to prostaglandin E2. In conclusion, celecoxib may be a promising therapeutic agent for LM management.

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Preoperative Facial Nerve Mapping to Plan and Guide Pediatric Facial Vascular Anomaly Resection

Cited by 22 publications

References 12 publications

Altered facial muscle innervation pattern in patients with postparetic facial synkinesis

Altered facial muscle innervation pattern in patients with postparetic facial synkinesis

Facial nerve electrodiagnostics for patients with facial palsy: a clinical practice guideline

Celecoxib as a Potential Treatment for Intractable Lymphatic Malformation

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