Facial nerve monitoring in parotid gland surgery: Design and feasibility assessment of a potential standardized technique
Abstract Background Even though the use of nerve monitoring during parotid gland surgery is not the gold standard to prevent damage to the nerve, it surely offers some advantages over the traditional approach. Different from thyroid surgery, where a series of steps in intraoperative nerve monitoring...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-12-01
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| Series: | World Journal of Otorhinolaryngology-Head and Neck Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/wjo2.90 |
| _version_ | 1797404497011539968 |
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| author | Carlos S. Duque Andrés F. Londoño Ana M. Duque Jhon J. Zuleta Marcela Marulanda Lina M. Otálvaro Miguel Agudelo Juan P. Dueñas María F. Palacio Gianlorenzo Dionigi |
| author_facet | Carlos S. Duque Andrés F. Londoño Ana M. Duque Jhon J. Zuleta Marcela Marulanda Lina M. Otálvaro Miguel Agudelo Juan P. Dueñas María F. Palacio Gianlorenzo Dionigi |
| author_sort | Carlos S. Duque |
| collection | DOAJ |
| description | Abstract Background Even though the use of nerve monitoring during parotid gland surgery is not the gold standard to prevent damage to the nerve, it surely offers some advantages over the traditional approach. Different from thyroid surgery, where a series of steps in intraoperative nerve monitoring have been described to confirm not only the integrity but—most importantly—the function of the recurrent laryngeal nerve, in parotid gland surgery, a formal guideline to follow while dissecting the facial nerve has yet to be described. Methods A five‐year retrospective study was done reviewing the intraoperative records of patients who underwent parotid gland surgery under neural monitoring. The operative findings regarding the neuromonitoring process, particularly in regard to the amplitude of two main branches, were revised. A literature search was done to search for guidelines to follow when a facial nerve loss of signal is encountered. Results Fifty‐five patients were operated on using the Nim 3 Nerve Monitoring System (Medtronic); 31 were female patients, and 47 patients had benign lesions. Minimum changes were observed in the amplitude records after a comparison was made between the first and the last stimulation. There were only three articles discussing the term loss of signal during parotid gland surgery. Conclusion Today, no sufficient attention has been given to the facial nerve monitoring process during parotidectomy. This study proposes a formal guideline to follow during this procedure as well as an instruction to consider when a loss of signal is observed to develop a uniform technique of facial nerve stimulation |
| first_indexed | 2024-03-09T02:55:50Z |
| format | Article |
| id | doaj.art-2e3d721ac70e41e9bafba59262679d20 |
| institution | Directory Open Access Journal |
| issn | 2095-8811 2589-1081 |
| language | English |
| last_indexed | 2024-03-09T02:55:50Z |
| publishDate | 2023-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | World Journal of Otorhinolaryngology-Head and Neck Surgery |
| spelling | doaj.art-2e3d721ac70e41e9bafba59262679d202023-12-05T06:26:41ZengWileyWorld Journal of Otorhinolaryngology-Head and Neck Surgery2095-88112589-10812023-12-019428028710.1002/wjo2.90Facial nerve monitoring in parotid gland surgery: Design and feasibility assessment of a potential standardized techniqueCarlos S. Duque0Andrés F. Londoño1Ana M. Duque2Jhon J. Zuleta3Marcela Marulanda4Lina M. Otálvaro5Miguel Agudelo6Juan P. Dueñas7María F. Palacio8Gianlorenzo Dionigi9Hospital Pablo Tobón Uribe Departmento de Cancerología Medellin ColombiaHospital Pablo Tobón Uribe Departmento de Cancerología Medellin ColombiaSección Otorrinolaringología, Departamento de Cirugía, Facultad de Medicina Universidad de Antioquia Medellín ColombiaHospital Pablo Tobón Uribe Dirección Científica Medellin ColombiaSección Cirugia de Cabeza y Cuello, Departamento de Cirugía, Facultad de Medicina Universidad de Antioquia Medellin ColombiaSección Otorrinolaringología, Departamento de Cirugía, Facultad de Medicina Universidad de Antioquia Medellín ColombiaDepartment of Internal Medicine Israel Medical Center Newark New Jersey USADepartamento de Cirugía Clínica El Rosario El Tesoro Medellín ColombiaSección Cabeza y Cuello, Instituto de Cancerología Clínica Las Américas – Auna Medellín ColombiaChirurgia Generale Capitanio Auxiologico Milan ItalyAbstract Background Even though the use of nerve monitoring during parotid gland surgery is not the gold standard to prevent damage to the nerve, it surely offers some advantages over the traditional approach. Different from thyroid surgery, where a series of steps in intraoperative nerve monitoring have been described to confirm not only the integrity but—most importantly—the function of the recurrent laryngeal nerve, in parotid gland surgery, a formal guideline to follow while dissecting the facial nerve has yet to be described. Methods A five‐year retrospective study was done reviewing the intraoperative records of patients who underwent parotid gland surgery under neural monitoring. The operative findings regarding the neuromonitoring process, particularly in regard to the amplitude of two main branches, were revised. A literature search was done to search for guidelines to follow when a facial nerve loss of signal is encountered. Results Fifty‐five patients were operated on using the Nim 3 Nerve Monitoring System (Medtronic); 31 were female patients, and 47 patients had benign lesions. Minimum changes were observed in the amplitude records after a comparison was made between the first and the last stimulation. There were only three articles discussing the term loss of signal during parotid gland surgery. Conclusion Today, no sufficient attention has been given to the facial nerve monitoring process during parotidectomy. This study proposes a formal guideline to follow during this procedure as well as an instruction to consider when a loss of signal is observed to develop a uniform technique of facial nerve stimulationhttps://doi.org/10.1002/wjo2.90amplitudefacial nerveintraoperative neural monitoringlatencyloss of signalnerve monitoring |
| spellingShingle | Carlos S. Duque Andrés F. Londoño Ana M. Duque Jhon J. Zuleta Marcela Marulanda Lina M. Otálvaro Miguel Agudelo Juan P. Dueñas María F. Palacio Gianlorenzo Dionigi Facial nerve monitoring in parotid gland surgery: Design and feasibility assessment of a potential standardized technique World Journal of Otorhinolaryngology-Head and Neck Surgery amplitude facial nerve intraoperative neural monitoring latency loss of signal nerve monitoring |
| title | Facial nerve monitoring in parotid gland surgery: Design and feasibility assessment of a potential standardized technique |
| title_full | Facial nerve monitoring in parotid gland surgery: Design and feasibility assessment of a potential standardized technique |
| title_fullStr | Facial nerve monitoring in parotid gland surgery: Design and feasibility assessment of a potential standardized technique |
| title_full_unstemmed | Facial nerve monitoring in parotid gland surgery: Design and feasibility assessment of a potential standardized technique |
| title_short | Facial nerve monitoring in parotid gland surgery: Design and feasibility assessment of a potential standardized technique |
| title_sort | facial nerve monitoring in parotid gland surgery design and feasibility assessment of a potential standardized technique |
| topic | amplitude facial nerve intraoperative neural monitoring latency loss of signal nerve monitoring |
| url | https://doi.org/10.1002/wjo2.90 |
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