High variability of facial muscle innervation by facial nerve branches: A prospective electrostimulation study.

Authors:
Gerd Fabian Volk
Gerd Fabian Volk
Jena University Hospital
Germany
Nikolas Eckhardt
Nikolas Eckhardt
University of Applied Sciences Technikum Wien
Orlando Guntinas-Lichius
Orlando Guntinas-Lichius
Jena University Hospital
Germany

Laryngoscope 2017 06 18;127(6):1288-1295. Epub 2016 Oct 18.

Department of Otorhinolaryngology and Facial Nerve Center Jena, Jena University Hospital, Jena, Germany.

Objectives/hypothesis: To examine by intraoperative electric stimulation which peripheral facial nerve (FN) branches are functionally connected to which facial muscle functions.

Study Design: Single-center prospective clinical study.

Methods: Seven patients whose peripheral FN branching was exposed during parotidectomy under FN monitoring received a systematic electrostimulation of each branch starting with 0.1 mA and stepwise increase to 2 mA with a frequency of 3 Hz. The electrostimulation and the facial and neck movements were video recorded simultaneously and evaluated independently by two investigators.

Results: A uniform functional allocation of specific peripheral FN branches to a specific mimic movement was not possible. Stimulation of the whole spectrum of branches of the temporofacial division could lead to eye closure (orbicularis oculi muscle function). Stimulation of the spectrum of nerve branches of the cervicofacial division could lead to reactions in the midface (nasal and zygomatic muscles) as well as around the mouth (orbicularis oris and depressor anguli oris muscle function). Frontal and eye region were exclusively supplied by the temporofacial division. The region of the mouth and the neck was exclusively supplied by the cervicofacial division. Nose and zygomatic region were mainly supplied by the temporofacial division, but some patients had also nerve branches of the cervicofacial division functionally supplying the nasal and zygomatic region.

Conclusions: FN branches distal to temporofacial and cervicofacial division are not necessarily covered by common facial nerve monitoring. Future bionic devices will need a patient-specific evaluation to stimulate the correct peripheral nerve branches to trigger distinct muscle functions.

Level Of Evidence: 4 Laryngoscope, 127:1288-1295, 2017.

Download full-text PDF

Source
http://dx.doi.org/10.1002/lary.26349DOI Listing

Still can't find the full text of the article?

Sign up to send a request to the authors directly.
June 2017
10 Reads

Publication Analysis

Top Keywords

nerve branches
20
cervicofacial division
16
temporofacial division
12
facial nerve
12
division lead
8
branches
8
muscle function
8
branches cervicofacial
8
supplied temporofacial
8
exclusively supplied
8
nasal zygomatic
8
facial muscle
8
stimulation spectrum
8
division
7
nerve
6
facial
6
muscle
5
muscles well
4
mouth orbicularis
4
zygomatic muscles
4

References

(Supplied by CrossRef)

Berkovitz et al.
2005
Surgical anatomy of the facial nerve and parotid gland based upon a study of 350 cervicofacial halves
Davis et al.
Surg Gyn Obstr 1956
The extratemporal facial nerve
Proctor et al.
Otolaryngol Head Neck Surg 1984
Über die periphere Ausbreitung des N. facialis beim Menschen
Fujita et al.
Gegenbaurs Morphol Jahrb 1934
The anatomy of the facial nerve
Monkhouse et al.
Ear Nose Throat J 1990

Angelov et al.
2016

Similar Publications