gms | German Medical Science

87. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

04.05. - 07.05.2016, Düsseldorf

Variability of The Facial Muscle Innervation of Peripheral Facial Nerve Branches: An Intraoperative Facial Nerve Electrostimulation Study

Meeting Abstract

Suche in Medline nach

  • Ashraf Raslan - HNO-Klinik des Universitätsklinikums Jena, Jena
  • corresponding author Gerd Fabian Volk - HNO-Klinik des Universitätsklinikums Jena, Jena
  • Orlando Guntinas-Lichius - HNO-Klinik des Universitätsklinikums Jena, Jena

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 87. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Düsseldorf, 04.-07.05.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. Doc16hnod625

doi: 10.3205/16hnod625, urn:nbn:de:0183-16hnod6253

Veröffentlicht: 30. März 2016

© 2016 Raslan et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Introduction: Most reports on variability of the innervation of the facial muscles by the facial nerve describe only the anatomy, but not the functional connectivity. Therefore, we systematically assessed via intraoperative electrical stimulation of the peripheral facial nerve branches the supply of the facial muscles.

Methods: During lateral parotidectomy in 5 patients, the facial nerve and its main branches were exposed under an operating microscope. Electrical stimulation (3 Hz, 30 Hz, 0.1-2 mA) of the facial nerve main stem and of all branches was performed and video recorded. Simultaneously, the response of facial muscle contraction was video recorded via a second camera. Offline, all parallel video sequences were qualitatively analysed.

Results: Stimulation of temporofacial division produced contraction of the orbicularis oculi muscle (OOcM) and zygomatic muscles (ZM) in 2 patients, of the nasalis muscle (NM) in 2 patients, of the OOcM together with the frontalis muscles (FM) in 1 patient, while the frontal branch proximally produced contraction of OOcM in 2 patient, and distally produced selectively contraction only of upper OOcM in 3 patients and FM in 2 patients. The zygomatic branch produced contraction of lower OOcM in 3 patients and of the complete OOcM in 2 patients. Stimulation of cervicofacial division produced contraction of orbicularis oris muscle (OOrM) and depressor anguli oris (DAM) muscles in 1 patient, of ZM in 2 patients while the buccalis branch stimulated the OOrM in 5 patients together with ZM in 1 patient and with DAM in 1 patient. The marginal mandibular branch stimulated the DAM in 4 patients.

Conclusion: A selective stimulation of facial nerve branches producing a selective contraction of a single facial muscle is possible.

Supported by: DAAD

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