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THE USE OF NERVE MONITORIZATION IN PAROTID, SUBMANDIBULAR GLAND AND FACIAL SURGERY AND ITS EFFECT ON PROGNOSIS

Year 2024, , 142 - 148, 20.08.2024
https://doi.org/10.24938/kutfd.1402951

Abstract

Objective: The facial nerve and its branches are at risk during facial surgery. The surgery with the highest risk is parotid and submandibular gland surgery. An attempt was made to determine threshold values in terms of paralysis in nerve monitoring parameters. These determined values could not be used to predict facial nerve function after surgery. The aim of this study is to investigate the relationship between the parameters detected by nerve stimulation during surgery and postoperative facial nerve dysfunction in patients who underwent parotid and submandibular gland surgery.
Material and Methods: A total of 29 facial nerve branches of 13 patients who underwent superficial parotidectomy or submandibular gland resection were examined. Patients were examined in two groups: those who did not develop paralysis after surgery and those who developed paralysis or sequelae. The relationship between the patient's pre- and postoperative House-Brackmann staging and potential changes detected during surgery was investigated.
Results: Paralysis was detected in 8 of 29 nerves that were stimulated, and the affected branches were the cervicofacial branch and the marginal mandibular branch. No difference was observed in the mean threshold stimulation values and responses determined before, during and at the end of dissection between patients who developed paralysis and those who did not.
Conclusion: Unlike the literature, it is determined that no electrophysiological measurement result can predict the postoperative phase as a result of ROC-curve analysis and logistic regression analysis. It is thought that these results are caused by the fact that the developing paralysis is at low stages and heal within one month.

Supporting Institution

Kırıkkale University Scientific Research Project 2021/092

Project Number

Kırıkkale Üniversitesi Bilimsel Araştırma Projesi 2121/092

References

  • Kinoshita I, Kawata R, Higashino M, Nishikawa S, Terada T, Haginomori SI. Effectiveness of intraoperative facial nerve monitoring and risk factors related to postoperative facial nerve paralysis in patients with benign parotid tumors: A 20-year study with 902 patients. Auris Nasus Larynx. 2021;48(3):361-367.
  • Albosaily A, Aldrees T, Doubi A, et al. Factors associated with facial weakness following surgery for benign parotid disease: a retrospective multicenter study. Ann Saudi Med. 2020;40(5):408-416.
  • Harper CM, Daube JR. Facial nerve electromyography and other cranial nerve monitoring. J Clin Neurophysiol. 1998;15(3):206-216.
  • Neff BA, Ting J, Dickinson SL, Welling DB. Facial nerve monitoring parameters as a predictor of postoperative facial nerve outcomes after vestibular schwannoma resection. Otol Neurotol. 2005;26(4):728-732.
  • Sajisevi M. Indications for Facial Nerve Monitoring During Parotidectomy. Otolaryngol Clin North Am. 2021;54(3):489-496.
  • Haring CT, Ellsperman SE, Edwards BM, et al. Assessment of Intraoperative Nerve Monitoring Parameters Associated With Facial Nerve Outcome in Parotidectomy for Benign Disease. JAMA Otolaryngol Head Neck Surg. 2019;145(12):1137-1143.
  • Eisele DW, Wang SJ, Orloff LA. Electrophysiologic facial nerve monitoring during parotidectomy. Head Neck. 2010;32(3):399-405.
  • Wallerius KP, Xie KZ, Lu LY, et al. Selective Deep Lobe Parotidectomy vs Total Parotidectomy for Patients With Benign Deep Lobe Parotid Tumors. JAMA Otolaryngol Head Neck Surg. 2023;149(11):1003-1110.
  • Isaacson B, Kileny PR, El-Kashlan H, Gadre AK. Intraoperative monitoring and facial nerve outcomes after vestibular schwannoma resection. Otol Neurotol. 2003;24(5):812-817.
  • Faden DL, Orloff LA, Ayeni T, Fink DS, Yung K. Stimulation threshold greatly affects the predictive value of intraoperative nerve monitoring. Laryngoscope. 2015;125(5):1265-1270.
  • Grosheva M, Klussmann JP, Grimminger C, et al. Electromyographic facial nerve monitoring during parotidectomy for benign lesions does not improve the outcome of postoperative facial nerve function: a prospective two-center trial. Laryngoscope. 2009;119(12):2299-2305.
  • Meier JD, Wenig BL, Manders EC, Nenonene EK. Continuous intraoperative facial nerve monitoring in predicting postoperative injury during parotidectomy. Laryngoscope. 2006;116(9):1569-1572.

Parotis, Submandibuler Bez ve Yüz Bölgesi Cerrahisinde Sinir Monitörizasyonu Kullanımı ve Prognoza Etkisi

Year 2024, , 142 - 148, 20.08.2024
https://doi.org/10.24938/kutfd.1402951

Abstract

Amaç: Yüz bölgesi cerrahisi sırasında fasiyal sinir ve dalları risk altındadır. Bu riskin en fazla olduğu cerrahi ise parotis ve submandibuler bez cerrahisidir. Sinir monitörizasyon parametrelerinde paralizi açısından sınır değerler saptanmaya çalışılmıştır. Saptanan bu değerler cerrahi sonu fasiyal sinir fonksiyonunu tahmin etmekte kullanılamamıştır. Bu çalışmanın amacı parotis ve submandibuler beza cerrahi uygulanan hastalarda sinir stimülatörü kullanımı ile cerrahisi sırasında saptanan parametrelerin postoperatif fasiyal sinir fonksiyon bozukluğu ile ilişkilisinin araştırılmasıdır.
Gereç ve Yöntemler: Çalışmaya parotis veya submandibular bezde kitle nedeniyle opere edilen ve preoperative fasiyal fonksiyonları doğal olan 13 hastanın toplam 29 fasiyal sinir dalı incelenmiştir. Hastalar cerrahi sonrası paralizi gelişmeyen ve paralizi veya sekel gelişen olmak üzere iki grupta incelenmiştir. Hastanın cerrahi öncesi ve sonrası House-Brackmann Evrelemesi ile cerrahi sırasında saptanan potansiyel değişiklikleri arasındaki ilişki araştırılmıştır.
Bulgular: Uyarım yapılan 29 sinirden 8’inde paralizi saptanmış olup etkilenen dallar servikofasiyal dal ve marjinal mandibular daldı. Paralizi gelişen ve gelişmeyen hastalar arasında diseksiyon öncesi, diseksiyon sırasında ve sonunda saptanan ortalama eşik uyarılma değerleri ve cevapları arasında fark gözlenmedi.
Sonuç: Literatürden farklı olarak yapılan ROC-curve analizi ve Logistic Regression analizi sonunda hiçbir elektrofizyolojik ölçüm sonucunun postoperatif evreyi öngöremediği saptandı. Gelişen paralizilerin düşük evrede olması ve 1 ay içerisinde iyileşmesinin bu sonuçlara neden olduğu düşünüldü.

Supporting Institution

Kırıkkale Üniversitesi Bilimsel Araştırma Projesi 2121/092

Project Number

Kırıkkale Üniversitesi Bilimsel Araştırma Projesi 2121/092

References

  • Kinoshita I, Kawata R, Higashino M, Nishikawa S, Terada T, Haginomori SI. Effectiveness of intraoperative facial nerve monitoring and risk factors related to postoperative facial nerve paralysis in patients with benign parotid tumors: A 20-year study with 902 patients. Auris Nasus Larynx. 2021;48(3):361-367.
  • Albosaily A, Aldrees T, Doubi A, et al. Factors associated with facial weakness following surgery for benign parotid disease: a retrospective multicenter study. Ann Saudi Med. 2020;40(5):408-416.
  • Harper CM, Daube JR. Facial nerve electromyography and other cranial nerve monitoring. J Clin Neurophysiol. 1998;15(3):206-216.
  • Neff BA, Ting J, Dickinson SL, Welling DB. Facial nerve monitoring parameters as a predictor of postoperative facial nerve outcomes after vestibular schwannoma resection. Otol Neurotol. 2005;26(4):728-732.
  • Sajisevi M. Indications for Facial Nerve Monitoring During Parotidectomy. Otolaryngol Clin North Am. 2021;54(3):489-496.
  • Haring CT, Ellsperman SE, Edwards BM, et al. Assessment of Intraoperative Nerve Monitoring Parameters Associated With Facial Nerve Outcome in Parotidectomy for Benign Disease. JAMA Otolaryngol Head Neck Surg. 2019;145(12):1137-1143.
  • Eisele DW, Wang SJ, Orloff LA. Electrophysiologic facial nerve monitoring during parotidectomy. Head Neck. 2010;32(3):399-405.
  • Wallerius KP, Xie KZ, Lu LY, et al. Selective Deep Lobe Parotidectomy vs Total Parotidectomy for Patients With Benign Deep Lobe Parotid Tumors. JAMA Otolaryngol Head Neck Surg. 2023;149(11):1003-1110.
  • Isaacson B, Kileny PR, El-Kashlan H, Gadre AK. Intraoperative monitoring and facial nerve outcomes after vestibular schwannoma resection. Otol Neurotol. 2003;24(5):812-817.
  • Faden DL, Orloff LA, Ayeni T, Fink DS, Yung K. Stimulation threshold greatly affects the predictive value of intraoperative nerve monitoring. Laryngoscope. 2015;125(5):1265-1270.
  • Grosheva M, Klussmann JP, Grimminger C, et al. Electromyographic facial nerve monitoring during parotidectomy for benign lesions does not improve the outcome of postoperative facial nerve function: a prospective two-center trial. Laryngoscope. 2009;119(12):2299-2305.
  • Meier JD, Wenig BL, Manders EC, Nenonene EK. Continuous intraoperative facial nerve monitoring in predicting postoperative injury during parotidectomy. Laryngoscope. 2006;116(9):1569-1572.
There are 12 citations in total.

Details

Primary Language English
Subjects Health Services and Systems (Other)
Journal Section Özgün Araştırma
Authors

Ela Cömert 0000-0001-7739-2717

Elif Çetinkaya 0000-0001-8618-3415

Buğra Şimşek 0000-0001-8968-7723

Ziya Şencan 0000-0002-0936-5108

Nuray Bayar Muluk 0000-0003-3602-9289

Bülent Bakar 0000-0002-6236-7647

Project Number Kırıkkale Üniversitesi Bilimsel Araştırma Projesi 2121/092
Publication Date August 20, 2024
Submission Date December 12, 2023
Acceptance Date February 27, 2024
Published in Issue Year 2024

Cite

APA Cömert, E., Çetinkaya, E., Şimşek, B., Şencan, Z., et al. (2024). THE USE OF NERVE MONITORIZATION IN PAROTID, SUBMANDIBULAR GLAND AND FACIAL SURGERY AND ITS EFFECT ON PROGNOSIS. The Journal of Kırıkkale University Faculty of Medicine, 26(2), 142-148. https://doi.org/10.24938/kutfd.1402951
AMA Cömert E, Çetinkaya E, Şimşek B, Şencan Z, Bayar Muluk N, Bakar B. THE USE OF NERVE MONITORIZATION IN PAROTID, SUBMANDIBULAR GLAND AND FACIAL SURGERY AND ITS EFFECT ON PROGNOSIS. Kırıkkale Üni Tıp Derg. August 2024;26(2):142-148. doi:10.24938/kutfd.1402951
Chicago Cömert, Ela, Elif Çetinkaya, Buğra Şimşek, Ziya Şencan, Nuray Bayar Muluk, and Bülent Bakar. “THE USE OF NERVE MONITORIZATION IN PAROTID, SUBMANDIBULAR GLAND AND FACIAL SURGERY AND ITS EFFECT ON PROGNOSIS”. The Journal of Kırıkkale University Faculty of Medicine 26, no. 2 (August 2024): 142-48. https://doi.org/10.24938/kutfd.1402951.
EndNote Cömert E, Çetinkaya E, Şimşek B, Şencan Z, Bayar Muluk N, Bakar B (August 1, 2024) THE USE OF NERVE MONITORIZATION IN PAROTID, SUBMANDIBULAR GLAND AND FACIAL SURGERY AND ITS EFFECT ON PROGNOSIS. The Journal of Kırıkkale University Faculty of Medicine 26 2 142–148.
IEEE E. Cömert, E. Çetinkaya, B. Şimşek, Z. Şencan, N. Bayar Muluk, and B. Bakar, “THE USE OF NERVE MONITORIZATION IN PAROTID, SUBMANDIBULAR GLAND AND FACIAL SURGERY AND ITS EFFECT ON PROGNOSIS”, Kırıkkale Üni Tıp Derg, vol. 26, no. 2, pp. 142–148, 2024, doi: 10.24938/kutfd.1402951.
ISNAD Cömert, Ela et al. “THE USE OF NERVE MONITORIZATION IN PAROTID, SUBMANDIBULAR GLAND AND FACIAL SURGERY AND ITS EFFECT ON PROGNOSIS”. The Journal of Kırıkkale University Faculty of Medicine 26/2 (August 2024), 142-148. https://doi.org/10.24938/kutfd.1402951.
JAMA Cömert E, Çetinkaya E, Şimşek B, Şencan Z, Bayar Muluk N, Bakar B. THE USE OF NERVE MONITORIZATION IN PAROTID, SUBMANDIBULAR GLAND AND FACIAL SURGERY AND ITS EFFECT ON PROGNOSIS. Kırıkkale Üni Tıp Derg. 2024;26:142–148.
MLA Cömert, Ela et al. “THE USE OF NERVE MONITORIZATION IN PAROTID, SUBMANDIBULAR GLAND AND FACIAL SURGERY AND ITS EFFECT ON PROGNOSIS”. The Journal of Kırıkkale University Faculty of Medicine, vol. 26, no. 2, 2024, pp. 142-8, doi:10.24938/kutfd.1402951.
Vancouver Cömert E, Çetinkaya E, Şimşek B, Şencan Z, Bayar Muluk N, Bakar B. THE USE OF NERVE MONITORIZATION IN PAROTID, SUBMANDIBULAR GLAND AND FACIAL SURGERY AND ITS EFFECT ON PROGNOSIS. Kırıkkale Üni Tıp Derg. 2024;26(2):142-8.

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