Rapid and accurate identification of cut ends of facial nerves using a nerve monitoring system during surgical exploration and anastomosis

Abstract

Purpose: Surgical exploration and end-to-end neurorrhaphy is the preferred management for traumatic facial nerve injury. Traditionally, finding the cut ends of facial nerves depends mainly on a surgeon's experience. In this study, a nerve monitoring system to help the surgeon quickly and accurately identify, confirm, and locate the cut ends of facial nerve branches was investigated.

Patients and methods: Six patients with traumatic facial nerve injury were selected, and the nerve monitoring system was applied during the surgical process of facial nerve exploration and anastomosis. Operation time and surgical outcome were used to evaluate the effect of this method.

Results: The surgical procedures required 6 to 15 minutes (mean, 10 minutes) for detecting and dissecting each cut end of a facial nerve branch. All cut ends of injured facial nerve branches were found during surgery in all 6 patients, and no intraoperative complications were encountered. The postoperative function of the facial nerve, evaluated by clinical examination and diagnostic electroneurography, was satisfactory and symmetrical in all 6 patients at 3 months.

Conclusion: Using a nerve monitoring system could effectively help surgeons achieve rapid and accurate identification of the cut ends of facial nerves during surgical facial nerve exploration for traumatic facial nerve injury.