Visualization of the Facial Nerve with Ultra-high-Frequency Ultrasound.

Autor:	Poelaert J; From the Plastic, Reconstructive and Aesthetic Surgery, UZ Gent, Ghent, Belgium., Coopman R; From the Plastic, Reconstructive and Aesthetic Surgery, UZ Gent, Ghent, Belgium., Ureel M; From the Plastic, Reconstructive and Aesthetic Surgery, UZ Gent, Ghent, Belgium., Dhooghe N; From the Plastic, Reconstructive and Aesthetic Surgery, UZ Gent, Ghent, Belgium., Genbrugge E; Radiology, UZ Gent, Ghent, Belgium., Mwewa T; Radiology, UZ Brussel, Brussels, Belgium., Blondeel P; From the Plastic, Reconstructive and Aesthetic Surgery, UZ Gent, Ghent, Belgium., Vermeersch H; From the Plastic, Reconstructive and Aesthetic Surgery, UZ Gent, Ghent, Belgium.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery. Global open [Plast Reconstr Surg Glob Open] 2023 Dec 19; Vol. 11 (12), pp. e5489. Date of Electronic Publication: 2023 Dec 19 (Print Publication: 2023).
DOI:	10.1097/GOX.0000000000005489
Abstrakt:	Background: Profound variations in facial nerve branching, combined with the severe impact of facial palsy on the patient's quality of life, make surgery in this region challenging. Recent advancements in ultrasound (US) technology, including the improved visualization of small structures, have led to a sharp increase in its medical indications in various medical disciplines. We aimed to prove the feasibility of using ultra-high-frequency (UHF) US to visualize the facial nerve and to guide surgeons during surgery on and around the facial nerve. Methods: A cadaveric study was performed on one hemi-face with a UHF US imaging system and state-of-the-art transducers. Firstly, a transcutaneous US was performed, and the facial nerve branches of interest (zygomatic, buccal, and marginal mandibular branches) were marked using US-guided color-injections of filler mixed with methylene blue. Skin and subcutaneous fat were then removed to simulate the intraoperative field. Secondly, an "intraoperative" US examination was performed, and the same branches were marked by US-guided color-injections of filler mixed with indocyanine green. Anterograde facial nerve dissection was performed, and the distance between the nerve branches and the injected filler was measured. Results: All color-injections (mixed with both methylene blue and indocyanine green) were positioned right next to the nerve branches (<1 mm). The image quality of the US below the skin was observed to be far superior to that of the transcutaneous US. Conclusion: UHF US can be used to visualize the facial nerve with high precision both transcutaneously and intraoperatively (after elevation of the skin flap). Competing Interests: The authors have no financial interest to declare in relation to the content of this article. Funding for this study was provided internally by the Department of Plastic, Reconstructive and Aesthetic Surgery, UZ Gent. (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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