Feasibility of an endoscope-dominated side-to-end hypoglossal-facial anastomosis: an anatomical study
ObjectiveA surgical simulation of an endoscope-dominated side-to-end hypoglossal-facial anastomosis was performed to evaluate the feasibility.MethodsEight anatomical cadaver heads (16 sides) were recruited. The steps in conventional procedures were abbreviated or omitted. A facial nerve was first ha...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-08-01
|
| Series: | Frontiers in Surgery |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1251527/full |
| _version_ | 1797740106442866688 |
|---|---|
| author | Xiaobing Yang Xiaobing Yang Dulegeqi Man Yang Yang Yang Yang Xingang Li Xingang Li |
| author_facet | Xiaobing Yang Xiaobing Yang Dulegeqi Man Yang Yang Yang Yang Xingang Li Xingang Li |
| author_sort | Xiaobing Yang |
| collection | DOAJ |
| description | ObjectiveA surgical simulation of an endoscope-dominated side-to-end hypoglossal-facial anastomosis was performed to evaluate the feasibility.MethodsEight anatomical cadaver heads (16 sides) were recruited. The steps in conventional procedures were abbreviated or omitted. A facial nerve was first harvested near its external genu and was used for a side-to-end hypoglossal-facial anastomosis. The stump of the used facial nerve was truncated and recycled immediately caudal to the facial recess in another anastomosis and then recycled again at the stylomastoid foramen. As a recycled stump becomes too short to ensure a side-to-end anastomosis, the hypoglossal nerve was transected in situ, and an endoscopic end-to-end hypoglossal-facial anastomosis was attempted. Surgical simulation and quantitative measurement methods were used to analyze the anastomosis effects of different harvested sites of the facial nerve.ResultsSeveral steps in the conventional procedures provide little benefit in endoscopic surgery. A facial nerve stump recycled at the stylomastoid foramen is too short to ensure a tensionless side-to-end anastomosis. An endoscopic end-to-end hypoglossal-facial anastomosis was feasible, although it required more time than the classical microsurgical anastomosis. The greater agility of an endoscope enables the conventional surgical steps to be overlapped or interweaved into the procedure.ConclusionsThe multiple surgical fields and ability to manipulate the viewpoint provided by an endoscope have brought about breakthroughs in classical surgical paradigms. In addition, it is best to choose the sites of the facial nerve harvested near the external genu. If unavailable, an alternative section site could be selected immediately caudal to the facial recess, but cannot be distal to the stylomastoid foramen. The length of the stump should be individualized and preferably optimized with a nerve stimulator. |
| first_indexed | 2024-03-12T14:07:45Z |
| format | Article |
| id | doaj.art-720a981026744ae6be140b19562fb37e |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-03-12T14:07:45Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-720a981026744ae6be140b19562fb37e2023-08-21T12:46:47ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-08-011010.3389/fsurg.2023.12515271251527Feasibility of an endoscope-dominated side-to-end hypoglossal-facial anastomosis: an anatomical studyXiaobing Yang0Xiaobing Yang1Dulegeqi Man2Yang Yang3Yang Yang4Xingang Li5Xingang Li6Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, ChinaJinan Microecological Biomedicine Shandong Laboratory and Shandong Key Laboratory of Brain Function Remodeling, Jinan, ChinaDepartment of Neurosurgery, International Mongolia Hospital of Inner Mongolia, Hohhot, ChinaDepartment of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, ChinaJinan Microecological Biomedicine Shandong Laboratory and Shandong Key Laboratory of Brain Function Remodeling, Jinan, ChinaDepartment of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, ChinaJinan Microecological Biomedicine Shandong Laboratory and Shandong Key Laboratory of Brain Function Remodeling, Jinan, ChinaObjectiveA surgical simulation of an endoscope-dominated side-to-end hypoglossal-facial anastomosis was performed to evaluate the feasibility.MethodsEight anatomical cadaver heads (16 sides) were recruited. The steps in conventional procedures were abbreviated or omitted. A facial nerve was first harvested near its external genu and was used for a side-to-end hypoglossal-facial anastomosis. The stump of the used facial nerve was truncated and recycled immediately caudal to the facial recess in another anastomosis and then recycled again at the stylomastoid foramen. As a recycled stump becomes too short to ensure a side-to-end anastomosis, the hypoglossal nerve was transected in situ, and an endoscopic end-to-end hypoglossal-facial anastomosis was attempted. Surgical simulation and quantitative measurement methods were used to analyze the anastomosis effects of different harvested sites of the facial nerve.ResultsSeveral steps in the conventional procedures provide little benefit in endoscopic surgery. A facial nerve stump recycled at the stylomastoid foramen is too short to ensure a tensionless side-to-end anastomosis. An endoscopic end-to-end hypoglossal-facial anastomosis was feasible, although it required more time than the classical microsurgical anastomosis. The greater agility of an endoscope enables the conventional surgical steps to be overlapped or interweaved into the procedure.ConclusionsThe multiple surgical fields and ability to manipulate the viewpoint provided by an endoscope have brought about breakthroughs in classical surgical paradigms. In addition, it is best to choose the sites of the facial nerve harvested near the external genu. If unavailable, an alternative section site could be selected immediately caudal to the facial recess, but cannot be distal to the stylomastoid foramen. The length of the stump should be individualized and preferably optimized with a nerve stimulator.https://www.frontiersin.org/articles/10.3389/fsurg.2023.1251527/fullhypoglossal-facial anastomosistransaditus approachendoscopicmastoidectomyfacial nerve reanimation |
| spellingShingle | Xiaobing Yang Xiaobing Yang Dulegeqi Man Yang Yang Yang Yang Xingang Li Xingang Li Feasibility of an endoscope-dominated side-to-end hypoglossal-facial anastomosis: an anatomical study Frontiers in Surgery hypoglossal-facial anastomosis transaditus approach endoscopic mastoidectomy facial nerve reanimation |
| title | Feasibility of an endoscope-dominated side-to-end hypoglossal-facial anastomosis: an anatomical study |
| title_full | Feasibility of an endoscope-dominated side-to-end hypoglossal-facial anastomosis: an anatomical study |
| title_fullStr | Feasibility of an endoscope-dominated side-to-end hypoglossal-facial anastomosis: an anatomical study |
| title_full_unstemmed | Feasibility of an endoscope-dominated side-to-end hypoglossal-facial anastomosis: an anatomical study |
| title_short | Feasibility of an endoscope-dominated side-to-end hypoglossal-facial anastomosis: an anatomical study |
| title_sort | feasibility of an endoscope dominated side to end hypoglossal facial anastomosis an anatomical study |
| topic | hypoglossal-facial anastomosis transaditus approach endoscopic mastoidectomy facial nerve reanimation |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1251527/full |
| work_keys_str_mv | AT xiaobingyang feasibilityofanendoscopedominatedsidetoendhypoglossalfacialanastomosisananatomicalstudy AT xiaobingyang feasibilityofanendoscopedominatedsidetoendhypoglossalfacialanastomosisananatomicalstudy AT dulegeqiman feasibilityofanendoscopedominatedsidetoendhypoglossalfacialanastomosisananatomicalstudy AT yangyang feasibilityofanendoscopedominatedsidetoendhypoglossalfacialanastomosisananatomicalstudy AT yangyang feasibilityofanendoscopedominatedsidetoendhypoglossalfacialanastomosisananatomicalstudy AT xingangli feasibilityofanendoscopedominatedsidetoendhypoglossalfacialanastomosisananatomicalstudy AT xingangli feasibilityofanendoscopedominatedsidetoendhypoglossalfacialanastomosisananatomicalstudy |