Quantitative facial electromyography monitoring after hypoglossal‐facial jump nerve suture

J, Flasar; Volk, Gerd Fabian; Granitzka, Thordis; Geißler, Katharina; Irintchev, Andrey; Guntinas‐Lichius, Orlando

doi:10.1002/lio2.95

Cited by 15 publications

(9 citation statements)

References 17 publications

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“…Moreover, following the repair surgery, MUPs re-appeared before the first clinical facial movements in our patients, which is consistent with the finding of Flasar et al [ 20 ]. The MUP amplitude increased gradually along with the improvement of facial nerve function.…”

Section: Discussionsupporting

confidence: 93%

Efficacy of surgical repair for the functional restoration of injured facial nerve

Fan

Wang

et al. 2021

BMC Surg

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Background Early surgical repair to restore nerve integrity has become the most commonly practiced method for managing facial nerve injury. However, the evidence for the efficacy of surgical repair for restoring the function of facial nerves remains deficient. This study evaluated the outcomes of surgical repair for facial nerve lesions. Methods This retrospective observational study recruited 28 patients with the diagnosis of facial nerve injury who consecutively underwent surgical repairs from September 2012 to May 2019. All related clinical data were retrospectively analyzed according to age, sex, location of the facial nerve lesion, size of the facial nerve defect, method of repair, facial electromyogram, and blink reflex. Facial function was then stratified with the House-Brackmann grading system pre-operation and 3, 9, 15, and 21 months after surgical repair. Results The 28 patients enrolled in this study included 17 male and 11 female patients with an average age of 34.3 ± 17.4 years. Three methods were applied for the repair of an injured facial nerve, including great auricular nerve transplantation in 15 patients, sural nerve grafting in 7 patients, and hypoglossal to facial nerve anastomosis in 6 patients. Facial nerve function was significantly improved at 21 months after surgery compared with pre-operative function (P = 0.008). Following surgical repair, a correlation was found between the amplitude of motor unit potential (MUP) and facial nerve function (r = -6.078, P = 0.02). Moreover, the extent of functional restoration of the facial nerve at 21 months after surgery depended on the location of the facial nerve lesion; lesions at either the horizontal or vertical segment showed significant improvement(P = 0.008 and 0.005), while no functional restoration was found for lesions at the labyrinthine segment (P = 0.26). Conclusions For surgical repair of facial nerve lesions, the sural nerve, great auricular nerve, and hypoglossal-facial nerve can be grafted effectively to store the function of a facial nerve, and MUP may provide an effective indicator for monitoring the recovery of the injured nerve.

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Section: Discussionsupporting

confidence: 93%

Efficacy of surgical repair for the functional restoration of injured facial nerve

Fan

Wang

et al. 2021

BMC Surg

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“…If the examination detects polyphasic regeneration potentials this indicates reinnervation. If the lesion site is located in the temporal bone or at the main trunk of the peripheral facial nerve, it can take 3-6 months to see the first regeneration potentials [35]. That means that the electrophysiological signs of regeneration precede the clinical signs of recovery.…”

Section: Interpretation Of the Nemg Resultsmentioning

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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“…Also, it was stated by Flasar in 2017 [34], that reinnervation can be detected at least 2 months earlier by EMG than by clinical evaluation. Changes should be followed for at least 18 months to assess the outcome.…”

Section: Discussionmentioning

confidence: 99%

Hypoglossal Facial Nerve Anastomosis for Post-Operative and Post-Traumatic Complete Facial Nerve Paralysis

Elkatatny

Abdallah

Ghoraba

et al. 2019

Open Access Maced J Med Sci

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AIM: This study aims to evaluate the outcome of patients with complete facial paralysis following surgery to cerebellopontine angle tumours or following traumatic petrous bone fractures after reanimation by hypoglossal-facial anastomosis as regards clinical improvement of facial asymmetry and facial muscle contractility as well as complications associated with hypoglossal-facial reanimation procedure. METHODS: This thesis included a prospective study to be carried out on 15 patients with unilateral complete lower motor neuron facial paralysis (11 patients after cerebellopontine angle tumour resection and 4 patients after traumatic transverse petrous bone fracture) operated upon by end to end hypoglossal-facial nerve anastomosis in Cairo university hospitals in the period between June 2015 and January 2017. RESULTS: At one year follow up the improvement of facial nerve functions were as follows: Three cases (20%) had improved to House Hrackmann grade II, eleven cases (73.33%) had improved to grade III, and one patient (6.66%) had improved to House Brackmann grade IV. CONCLUSION: Despite the various techniques in facial reanimation following facial nerve paralysis, the end to end hypoglossal-facial nerve anastomosis remains the gold standard procedure with satisfying results in cases of the viable distal facial stump and non-atrophic muscles. Early hypoglossal-facial anastomotic repair after acute facial nerve injury is associated with better long-term facial function outcomes and should be considered in the management algorithm.

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Quantitative facial electromyography monitoring after hypoglossal‐facial jump nerve suture

Cited by 15 publications

References 17 publications

Efficacy of surgical repair for the functional restoration of injured facial nerve

Efficacy of surgical repair for the functional restoration of injured facial nerve

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

Hypoglossal Facial Nerve Anastomosis for Post-Operative and Post-Traumatic Complete Facial Nerve Paralysis

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