Improved facial nerve identification during parotidectomy with fluorescently labeled peptide

Hussain, Timon; Nguyen, Linda; Whitney, Michael; Hasselmann, Jonathan; Nguyen, Quyen T.

doi:10.1002/lary.26057

Cited by 19 publications

(9 citation statements)

References 36 publications

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“…82–85 In 1 preclinical study, facial nerve imaging in murine models with the fluorescently labeled peptide NP41 demonstrated increased nerve to surrounding tissue contrast by a factor of 2.86 ( P = 0.005). 86 FI significantly improved detection of additional nerve branches, particularly those underlying surrounding tissue (7.50 ± 1.60 small nerve branches vs 3.25 ± 0.89 with white light). 86 Although nerve imaging has not yet translated into clinical trials, these data suggest that concurrent nerve imaging, when combined with current imaging and monitoring techniques, can improve the functional outcomes and QOL in patients by improving nerve preservation.…”

Section: Discussionmentioning

confidence: 97%

“…86 FI significantly improved detection of additional nerve branches, particularly those underlying surrounding tissue (7.50 ± 1.60 small nerve branches vs 3.25 ± 0.89 with white light). 86 Although nerve imaging has not yet translated into clinical trials, these data suggest that concurrent nerve imaging, when combined with current imaging and monitoring techniques, can improve the functional outcomes and QOL in patients by improving nerve preservation. With emerging preclinical studies, there is, however, evidence to suggest that future intraoperative imaging will expand to include visualization of extratumoral structures and tissues.…”

Section: Discussionmentioning

confidence: 97%

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Oncologic Procedures Amenable to Fluorescence-guided Surgery

et al. 2017

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Objective: Although fluorescence imaging is being applied to a wide range of cancers, it remains unclear which disease populations will benefit greatest. Therefore, we review the potential of this technology to improve outcomes in surgical oncology with attention to the various surgical procedures while exploring trial endpoints that may be optimal for each tumor type. Background: For many tumors, primary treatment is surgical resection with negative margins, which corresponds to improved survival and a reduction in subsequent adjuvant therapies. Despite unfavorable effect on patient outcomes, margin positivity rate has not changed significantly over the years. Thus, patients often experience high rates of re-excision, radical resections, and overtreatment. However, fluorescence-guided surgery (FGS) has brought forth new light by allowing detection of subclinical disease not readily visible with the naked eye. Methods: We performed a systematic review of clinicatrials.gov using search terms ‘‘fluorescence,’’ ‘‘image-guided surgery,’’ and ‘‘near-infrared imaging’’ to identify trials utilizing FGS for those received on or before May 2016. Inclusion criteria: fluorescence surgery for tumor debulking, wide local excision, whole-organ resection, and peritoneal metastases. Exclusion criteria: fluorescence in situ hybridization, fluorescence imaging for lymph node mapping, nonmalignant lesions, nonsurgical purposes, or image guidance without fluorescence. Results: Initial search produced 844 entries, which was narrowed down to 68 trials. Review of literature and clinical trials identified 3 primary resection methods for utilizing FGS: (1) debulking, (2) wide local excision, and (3) whole organ excision. Conclusions: The use of FGS as a surgical guide enhancement has the potential to improve survival and quality of life outcomes for patients. And, as the number of clinical trials rise each year, it is apparent that FGS has great potential for a broad range of clinical applications.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 97%

Oncologic Procedures Amenable to Fluorescence-guided Surgery

et al. 2017

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“…Recent developments in intraoperative nerve visualization can be found in new uses of ultrasonography, fluorescent markers and optical coherence tomography (OCT) [15][16][17][18][19]. However, these methods have their drawbacks; blunt dissection of nerves is not without risk, due to the risk of traction-stretch neuropathy [10,20].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of collimated polarized light imaging for real-time intraoperative selective nerve identification in the human hand

Chin¹,

Engelsman²,

Chin³

et al. 2017

Biomed. Opt. Express

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Abstract:Intraoperative peripheral nerve lesions are common complications due to misidentification and limitations of surgical nerve identification. This study validates a realtime non-invasive intraoperative method of nerve identification. Long working distance collimated polarized light imaging (CPLi) was used to identify peripheral radial nerve branches in a human cadaver hand by their nerve specific anisotropic optical reflection. Seven ex situ and six in situ samples were examined for nerves, resulting after histological validation, in a 100% positive correct score (CPLi) versus 77% (surgeon). Nerves were visible during a clinical in vivo observation using CPLi. Therefore CPLi is a promising technique for intraoperative nerve identification. for high resolution fat-suppressed imaging of the brachial and lumbosacral plexuses," Eur.

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“…Oncologic surgery, in particular, poses a risk of nerve injury as anatomy is often distorted by the disease [10][11][12][13][14][15][16][17]. Tools for pre and perioperative nerve enhancement exist [18][19][20] and fluorescent nerve imaging agents, as well as multimodal optical imaging techniques, are raising interest for intraoperative applications [21][22][23][24][25][26][27][28][29][30][31].…”

Section: Introductionmentioning

confidence: 99%

Fluorescence labeling of a NaV1.7-targeted peptide for near-infrared nerve visualization

Gonzales

Pirovano

Chow

et al. 2020

Preprint

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Purpose Accidental peripheral nerve injury during surgical intervention results in a broad spectrum of potentially debilitating side effects. Tissue distortion and poor visibility can significantly increase the risk of nerve injury with long-lasting consequences for the patient. We developed and characterized Hs1a-FL, a fluorescent near-infrared molecule for nerve visualization in the operating theater with the aim of helping physicians to visualize nerves during surgery.Methods Hs1a was derived from the venom of the Chinese bird spider, Haplopelma schmidti , and conjugated to Cy7.5 dye. Hs1a-FL was injected intravenously in mice and harvested nerves were imaged microscopically and with epifluorescence.Results Hs1a-FL showed specific and stable binding to the sodium channel Na v 1.7, present on the surface of human and mouse nerves. Hs1a-FL allowed epifluorescence visualization of sciatic mouse nerves with favorable nerve-to-muscle contrast.Conclusions Fluorescent Na v 1.7-targeted tracers have the potential to be adopted clinically for the intraoperative visualization of peripheral nerves during surgery, providing guidance for the surgeon and potentially improving the standard of care.

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Improved facial nerve identification during parotidectomy with fluorescently labeled peptide

Cited by 19 publications

References 36 publications

Oncologic Procedures Amenable to Fluorescence-guided Surgery

Oncologic Procedures Amenable to Fluorescence-guided Surgery

Evaluation of collimated polarized light imaging for real-time intraoperative selective nerve identification in the human hand

Fluorescence labeling of a NaV1.7-targeted peptide for near-infrared nerve visualization

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