RESUMO
Abstract Objectives: The aim of this study was to assess the relationship between the stimulation amplitude and the distance to the facial nerve. Methods: This study was designed as a prospective clinical study. A total of 20 patients (12 males, 8 females) were included. Partial superficial parotidectomy was performed in all patients with intraoperative facial monitoring. Measurements were made on the main trunk and major branches. Stimulation was started at 1 mA and incrementally increased to 2 and 3mA's. The shortest distance creating a robust response (>100mV) was recorded. Results: At 1 mA, 2 mA and 3 mA stimulation intensity, the average distance between the tip of the stimulation probe and the main trunk was 2.20±0.76 mm (range 1-3 mm), 3.80±0.95 mm (range 2-5 mm), 4.80±1.05 mm (range 3-7 mm) respectively. The stimulus intensity was inversely proportional in respect to the distance between the nerve and the tip of the stimulus probe (P < .00). The same relation was present in the facial nerve major branch measurements (P < .00). Conclusion: The proportional stimulation amplitude and distance to the facial nerve is thought to be a reliable auxillary method to assist the surgeon by facilitating the estimation of the distance to the facial nerve during extracapsular dissection and minimally invasive cases where the facial nerve isn't routinely dissected. Level of evidence: Level 3.
RESUMO
OBJECTIVES: The aim of this study was to assess the relationship between the stimulation amplitude and the distance to the facial nerve. METHODS: This study was designed as a prospective clinical study. A total of 20 patients (12 males, 8 females) were included. Partial superficial parotidectomy was performed in all patients with intraoperative facial monitoring. Measurements were made on the main trunk and major branches. Stimulation was started at 1 mA and incrementally increased to 2 and 3 mA's. The shortest distance creating a robust response (>100 mV) was recorded. RESULTS: At 1 mA, 2 mA and 3 mA stimulation intensity, the average distance between the tip of the stimulation probe and the main trunk was 2.20 ± 0.76 mm (range 1-3 mm), 3.80 ± 0.95 mm (range 2-5 mm), 4.80 ± 1.05 mm (range 3-7 mm) respectively. The stimulus intensity was inversely proportional in respect to the distance between the nerve and the tip of the stimulus probe (P < .00). The same relation was present in the facial nerve major branch measurements (P < .00). CONCLUSION: The proportional stimulation amplitude and distance to the facial nerve is thought to be a reliable auxillary method to assist the surgeon by facilitating the estimation of the distance to the facial nerve during extracapsular dissection and minimally invasive cases where the facial nerve isn't routinely dissected. LEVEL OF EVIDENCE: Level 3.
Assuntos
Nervo Facial , Neoplasias Parotídeas , Masculino , Feminino , Humanos , Nervo Facial/cirurgia , Glândula Parótida/cirurgia , Neoplasias Parotídeas/cirurgia , Estudos Prospectivos , Monitorização Intraoperatória/métodosRESUMO
OBJECTIVE: According to the literature, periauricular combined with submandibular or cervical incision is used in nearly every parotidectomy. The aim of this study was to present the results of the use of only periauricular incision in parotid surgical procedures. DESIGN: A case series with planned data collection. SETTING: Patients of the author were operated on at the Hospital Santa Casa de Misericórdia de Belo Horizonte, Brazil. SUBJECTS AND METHODS: Forty-one consecutive partial or total parotidectomies (27 cases of pleomorphic adenoma, 9 of other benign tumors, 3 of parotid cysts, and 2 of chronic parotiditis) were performed using only periauricular incision. RESULTS: The parotid tumors were removed in all cases with no need for any further skin procedures, as the incisions produced a good aesthetic result. All patients presented temporary hypoesthesia in the area that had been operated on for no more than 6 months. Ear discomfort was reported by 18 patients for a short period of time. Local infection occurred in 1 case successfully treated with systemic antibiotics. CONCLUSION: The results of the present study indicate that periauricular incision is a high-quality and highly aesthetic option for surgical procedures concerning benign conditions of the parotid gland.