The Experts below are selected from a list of 303 Experts worldwide ranked by ideXlab platform
Nabil Hokayem - One of the best experts on this subject based on the ideXlab platform.
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treating Facial Nerve palsy by true termino lateral hypoglossal Facial Nerve anastomosis
Journal of Plastic Reconstructive and Aesthetic Surgery, 2010Co-Authors: Fadi H. Sleilati, Marwan Nasr, Henri A. Stephan, Z.d. Asmar, Nabil HokayemAbstract:Hypoglossal-Facial Nerve anastomosis is a time-proven technique for the repair of Facial Nerve palsy. Efforts have been made to reduce hypoglossal Nerve injury, the main drawback of the technique. In this study, the anastomosis is a true termino-lateral neurorrhaphy with only an epineural window in the hypoglossal Nerve sheath. A re-routing technique of the temporal Facial Nerve is also performed to allow a direct anastomosis to the hypoglossal Nerve without the need for a jump graft. The first three results reported are very encouraging, with a satisfactory return of Facial mimics and without any impairment of lingual function.
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Treating Facial Nerve palsy by true termino-lateral hypoglossal–Facial Nerve anastomosis
Journal of plastic reconstructive & aesthetic surgery : JPRAS, 2010Co-Authors: Fadi H. Sleilati, Marwan Nasr, Henri A. Stephan, Z.d. Asmar, Nabil HokayemAbstract:Hypoglossal-Facial Nerve anastomosis is a time-proven technique for the repair of Facial Nerve palsy. Efforts have been made to reduce hypoglossal Nerve injury, the main drawback of the technique. In this study, the anastomosis is a true termino-lateral neurorrhaphy with only an epineural window in the hypoglossal Nerve sheath. A re-routing technique of the temporal Facial Nerve is also performed to allow a direct anastomosis to the hypoglossal Nerve without the need for a jump graft. The first three results reported are very encouraging, with a satisfactory return of Facial mimics and without any impairment of lingual function.
M D Seidman - One of the best experts on this subject based on the ideXlab platform.
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Prediction of Facial Nerve function following acoustic neuroma resection using intraoperative Facial Nerve stimulation.
The Laryngoscope, 1994Co-Authors: H Silverstein, T O Willcox, S I Rosenberg, M D SeidmanAbstract:Methods of monitoring the Facial Nerve during posterior fossa surgery continue to evolve. In an effort to predict acute and final Facial Nerve function following acoustic neuroma resection, the lowest current applied to the Facial Nerve at the brainstem necessary to elicit Facial muscle response was measured using strain gauge and electromyographic Facial Nerve monitors. A retrospective analysis of 121 patients who had undergone acoustic neuroma surgery was performed. Sixty-five patients had intraoperative Facial Nerve monitoring and 44 had sufficient data for inclusion in this study. The acute and final Facial Nerve functions, according to the House-Brackmann classification, were assessed with regard to intraoperative stimulation-current thresholds. Nineteen of 20 patients who required 0.10 mA or less to elicit a Facial muscle response had a House-Brackmann grade I Facial Nerve outcome. The upper limit of the 95% confidence interval of stimulation threshold for patients with a final grade I Facial Nerve function is 0.17 mA. All of the patients in this study, with stimulation thresholds ranging up to 0.84 mA, had a final grade III or better result. A poor outcome in our series, a final grade III Facial Nerve function, is best predicted by a poor acute result, specifically an acute grade VIA Facial Nerve function. We suggest that it is possible to predict the Facial Nerve function based on intraoperative threshold testing.
Se Hyun Jeong - One of the best experts on this subject based on the ideXlab platform.
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Facial Nerve neurorrhaphy due to unexpected Facial Nerve injury during parotid gland tumor surgery
European Archives of Oto-Rhino-Laryngology, 2020Co-Authors: Se Hyun JeongAbstract:Background Unexpected Facial Nerve damage can occur during parotid gland tumor surgery. We sought to determine the incidence and treatment outcomes of unexpected Facial Nerve injuries in patients with parotid gland tumor surgery. Methods We retrospectively enrolled in this study five patients, who underwent Facial Nerve neurorrhaphy due to unexpected Facial Nerve injury during parotid gland tumor surgery January 2012–August 2019. Results There were five patients (0.008%) with unexpected Facial Nerve injuries during the parotid gland tumor surgery of 577 patients in our hospital for approximately 8 years. The most common injury site of Facial Nerve was the marginal mandibular branch ( n = 3), followed by the buccal branch ( n = 1), and the cervicoFacial division ( n = 1). In the case of unexpected Facial Nerve damage, our treatment is immediate primary neurorrhaphy and steroid treatment. Three patients of five recovered and two did not worsen immediately after surgery. Conclusion Unexpected Facial Nerve injury during parotid gland tumor surgery is extremely unfortunate. In this case, immediate primary neurorrhaphy and systemic steroids are recommended to restore Facial function and reduce cosmetic deficits.
Sang Chul Lim - One of the best experts on this subject based on the ideXlab platform.
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Facial Nerve neurorrhaphy due to unexpected Facial Nerve injury during parotid gland tumor surgery.
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated wi, 2020Co-Authors: Hyun Jeong, Hee Young Kim, Dong Hoon Lee, Joon Kyoo Lee, Sang Chul LimAbstract:Unexpected Facial Nerve damage can occur during parotid gland tumor surgery. We sought to determine the incidence and treatment outcomes of unexpected Facial Nerve injuries in patients with parotid gland tumor surgery. We retrospectively enrolled in this study five patients, who underwent Facial Nerve neurorrhaphy due to unexpected Facial Nerve injury during parotid gland tumor surgery January 2012–August 2019. There were five patients (0.008%) with unexpected Facial Nerve injuries during the parotid gland tumor surgery of 577 patients in our hospital for approximately 8 years. The most common injury site of Facial Nerve was the marginal mandibular branch (n = 3), followed by the buccal branch (n = 1), and the cervicoFacial division (n = 1). In the case of unexpected Facial Nerve damage, our treatment is immediate primary neurorrhaphy and steroid treatment. Three patients of five recovered and two did not worsen immediately after surgery. Unexpected Facial Nerve injury during parotid gland tumor surgery is extremely unfortunate. In this case, immediate primary neurorrhaphy and systemic steroids are recommended to restore Facial function and reduce cosmetic deficits.
Michael P. Schenk - One of the best experts on this subject based on the ideXlab platform.
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Facial Nerve in parotidectomy: a topographical analysis.
The Laryngoscope, 2004Co-Authors: C. Ron Cannon, William H. Replogle, Michael P. SchenkAbstract:Objective: Establish normative data concerning parotidectomy and Facial Nerve dissection and determine the relationship between the length of the Facial Nerve dissected during parotidectomy and subsequent Facial Nerve paresis. Study Design: Prospective mapping of Facial Nerve during parotidectomy and comparison with postoperative Facial Nerve function. Methods: A prospective observational study of 78 patients who underwent 79 parotidectomy procedures. During each procedure, various topographical measurements were recorded. These measurements included the distance from the tragal pointer to the main trunk of the Facial Nerve, the distance to the pes anserinus, and length of each segmental branch dissected. In addition, a designation of the patient's tumor location was made by drawing a line from the ear canal to the nasal spine. Tumors above this line were designated anatomic zone A and those below the line were designated anatomic zone B. Finally, Facial Nerve function was quantified at a 1-week follow-up visit using the House-Brackmann Scale. Results: The distance from the main trunk of the Facial Nerve to the tragal pointer was significantly (P < .000) less than the previously accepted standard of 1 cm. The cervical and marginal mandibular branches had more Nerve dissected, whereas the eye and forehead branches were the least dissected. Results of an independent t test and logistic regression (P = .01, both) indicated that patients with temporary Facial Nerve paresis had a significantly greater amount of Nerve dissected than patients without temporary Facial Nerve paresis. Patients with short-term Facial Nerve dysfunction had significantly (P < .01) more total Nerve dissected (136.73 mm vs. 94.73 mm) than patients without short-term Facial Nerve dysfunction. Patients with Nerve dissection lengths at the third quartile (130.0 mm) were 3.8 times more likely to experience temporary Facial Nerve paresis than patients with Nerve dissection lengths at the first quartile (64.5 mm). Conclusions: The axiom that the main trunk of the Facial Nerve is located 1 cm from the tragal pointer may need to be modified to less than 1 cm. The cervical and marginal mandibular branches had more Nerve dissected, whereas the eye and forehead branches were the least dissected. Facial Nerve paresis after parotidectomy is associated with the length of the Facial Nerve dissected during the procedure. The greater the length of Facial Nerve dissected, the higher the chance of Facial Nerve paresis, albeit temporarily, in this particular series of patients.
