“A Technique for Safe Deep Facial Tissue Dissection: Indocyanine Green–Assisted Intraoperative Real-time Visualization of the Vasa nervorum of Facial Nerve with a Near-infrared Camera”

Publication date: Available online 20 July 2019Source: Journal of Cranio-Maxillofacial SurgeryAuthor(s): Jin Geun Kwon, Young Jun Choi, Sung Chan Kim, Joon Pio Jp Hong, Woo Shik Jeong, Tae Suk OhAbstractDuring deep tissue dissection in the face, it is sometimes difficult to distinguish the facial nerve from surrounding tissue, leading to a risk of facial nerve injury. To identify the facial nerve during such procedures, we used a fluorescence-assisted near-infrared camera. Indocyanine green (ICG)-assisted direct visualization was used intraoperatively in 13 cases. The procedures included excision of neurofibromas (n=10) and lymphatic malformations (n=3). Intravenously injected ICG was distributed systemically and filled the lumen of epineural vessels around the nerves (vasa nervorum) within 1 minute. The nerve trajectories were directly visualized using a fluorescence-detecting near-infrared camera. The facial nerve was distinguishable from surrounding tissues such as retaining ligaments and, in all cases, was safely secured, preserving postoperative facial nerve function. Postoperative mean differences of left/right facial volume were significantly reduced compared with preoperative values. Patient satisfaction ranged from satisfied to very satisfied. Injuries to the facial nerve could be effectively avoided via direct intraoperative visualization of the vasa nervorum of nerve through intravenous ICG injection. A portable near-infrared camera enabled direct and real-time vis...
Source: Journal of Cranio Maxillofacial Surgery - Category: ENT & OMF Source Type: research

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Authors: Göker AE, Alagöz MH, Güntaş G, Baskadem Yilmazer A, Berkiten G, Tutar B, Ekincioglu ME, Akgun MF, Uyar Y, Ozdemir E Abstract OBJECTIVE: This prospective study aimed to evaluate the relationship between serum ischaemia-modified albumin levels and Bell's palsy severity. METHODS: The study included 30 patients diagnosed with Bell's palsy and 30 healthy individuals. The patients were separated into three disease severity groups (grades 2, 3 and 4) according to House-Brackmann classification. Blood samples were collected from all participants and the results compared between groups. RESU...
Source: Journal of Laryngology and Otology - Category: ENT & OMF Tags: J Laryngol Otol Source Type: research
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Source: Journal of Bone and Mineral Research - Category: Orthopaedics Authors: Tags: Original Article Source Type: research
The aim of this study was to assess surgically restored facial mobility using an optical 3D instrument. Eleven patients (age range 42 –76 years) with unilateral facial palsy, treated by triple innervation procedure (masseteric and partial hypoglossal reinnervation, plus double cross-face facial grafting), performed five facial animations: rest position, smiling by contracting the healthy side, clenching the teeth, and pushing th e tongue against the lower incisors and Mona Lisa smiling. These were recorded by stereophotogrammetry.
Source: International Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Authors: Tags: Research Paper Source Type: research
Conclusions: Bilateral facial palsy has various causes. Prognosis for recovery is good. PMID: 31430217 [PubMed - as supplied by publisher]
Source: Acta Oto-Laryngologica - Category: ENT & OMF Authors: Tags: Acta Otolaryngol Source Type: research
A 26-year-old female presented with acute onset distal paraparesis, upper limb tremor and bilateral facial palsy. Neurophysiology revealed a sensorimotor demyelinating polyneuropathy and lumbar puncture revealed an albuminocytologic dissociation. Neuroaxis MRI revealed bilateral facial nerve and cauda equina enhancement. Initially diagnosed as Guillain-Barr é Syndrome, poor response to intravenous immunoglobulin, persistent deterioration, anti-neurofascin-155 antibodies and clinical response to steroid therapy led to diagnosis of acute-onset chronic inflammatory demyelinating polyneuropathy (CIDP).
Source: Journal of Neuroimmunology - Category: Allergy & Immunology Authors: Tags: Short Communication Source Type: research
Conclusion: High-dose corticosteroids reduce nonrecovery in patients with Bell's palsy. The dose of high-dose corticosteroids was varied and further prospective study is needed to identify an adequate dose of corticosteroids in these patients.
Source: Otology and Neurotology - Category: ENT & OMF Tags: FACIAL NERVE Source Type: research
Conclusions: The overall incidence rate of delayed facial palsy after middle ear surgery was 0.65%; however, it differed depending on the type of surgery. The mean onset time of facial palsy was 8.47 ± 3.98 days after surgery, and 95.3% of the patients completely recovered. The disease seems to have multiple etiologies. Facial palsy occurring 2 to 20 days after surgery is suggested to be considered delayed facial palsy.
Source: Otology and Neurotology - Category: ENT & OMF Tags: FACIAL NERVE Source Type: research
ConclusionsShort- and long-term outcomes of MVD in patients with HFS manifested differently, but the outcomes at 6 and 9  months showed similarities with those at>  12 months. In patients in whom the intraoperatively detected offending vessel was not a vein, and in patients with intraoperative indentation on the facial nerve and postoperative delayed facial palsy, good outcomes could be predicted after 6 months of surgery.
Source: Acta Neurochirurgica - Category: Neurosurgery Source Type: research
AbstractAs polytrauma cases are on the rise, a large number of patients presents with temporal bone fractures, which can result in various types of injuries varying from trivial to more serious injuries. Early diagnosis and appropriate management in required in case of serious injuries for a better outcome. The aim of my study is to study the incidence, the different injuries occurring and the effect of early diagnosis on hearing loss. Patients coming to our emergency department with polytrauma are studied and clinically evaluated for any temporal bone injuries. Based on the type of injuries audiological and radiological s...
Source: Indian Journal of Otolaryngology and Head and Neck Surgery - Category: ENT & OMF Source Type: research
Objectives: To study the applicability of National Institutes of Health Stroke Scale (NIHSS) in early predicting the prognosis of poststroke dysphagia in an acute ward. Methods: This is an observational retrospective cohort study including adult patients with ischemic stroke. Patients with various factors affecting swallowing were excluded to obtain a representative sample of 165 patients. The main outcome measure was the improvements of oral intake function. Results: The scores of facial palsy (NIHSS item 4) (odds ratio [OR]: 0.484, 95% confidence interval [CI]: 0.279-0.838, P = .0096] and language/aphasia (NIHSS item 9) ...
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
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