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Correlations between the clinical, histological and neurophysiological examinations in patients before and after parotid gland tumor surgery: verification of facial nerve transmission.

Wiertel-Krawczuk A, Huber J, Wojtysiak M, Golusiński W, Pieńkowski P, Golusiński P - Eur Arch Otorhinolaryngol (2014)

Bottom Line: CMAP amplitudes after stimulation of mandibular marginal branch were reduced at about 25 % in patients with benign tumors after surgery.A similar trend was found for BR results.Needle EMG, ENG and BR examinations allow for the evaluation of face muscles reinnervation and facial nerve regeneration.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathophysiology of Locomotor Organs, Wiktor Dega Clinical Orthopaedic and Rehabilitation Hospital, University of Medical Sciences, 28 Czerwca 1956r. No 135/147, 61-545, Poznań, Poland, zpnr@wp.pl.

ABSTRACT
Parotid gland tumor surgery sometimes leads to facial nerve paralysis. Malignant more than benign tumors determine nerve function preoperatively, while postoperative observations based on clinical, histological and neurophysiological studies have not been reported in detail. The aims of this pilot study were evaluation and correlations of histological properties of tumor (its size and location) and clinical and neurophysiological assessment of facial nerve function pre- and post-operatively (1 and 6 months). Comparative studies included 17 patients with benign (n = 13) and malignant (n = 4) tumors. Clinical assessment was based on House-Brackmann scale (H-B), neurophysiological diagnostics included facial electroneurography [ENG, compound muscle action potential (CMAP)], mimetic muscle electromyography (EMG) and blink-reflex examinations (BR). Mainly grade I of H-B was recorded both pre- (n = 13) and post-operatively (n = 12) in patients with small (1.5-2.4 cm) benign tumors located in superficial lobes. Patients with medium size (2.5-3.4 cm) malignant tumors in both lobes were scored at grade I (n = 2) and III (n = 2) pre- and mainly VI (n = 4) post-operatively. CMAP amplitudes after stimulation of mandibular marginal branch were reduced at about 25 % in patients with benign tumors after surgery. In the cases of malignant tumors CMAPs were not recorded following stimulation of any branch. A similar trend was found for BR results. H-B and ENG results revealed positive correlations between the type of tumor and surgery with facial nerve function. Neurophysiological studies detected clinically silent facial nerve neuropathy of mandibular marginal branch in postoperative period. Needle EMG, ENG and BR examinations allow for the evaluation of face muscles reinnervation and facial nerve regeneration.

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Locations of surface stimulation and recording electrodes during CMAP examinations: A from frontal (a) and orbicularis oris (a) muscles and blink-reflex bilateral recordings; B from orbicularis oculi muscles in one of the healthy volunteers
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Fig2: Locations of surface stimulation and recording electrodes during CMAP examinations: A from frontal (a) and orbicularis oris (a) muscles and blink-reflex bilateral recordings; B from orbicularis oculi muscles in one of the healthy volunteers

Mentions: During ENG examinations time base was set on 5 ms/D, sensitivity of recordings on 2 mV/D. 10 Hz upper and 10 kHz lower filters of recorder amplifier were used. Standard (AgCl) surface electrodes were used for recording of compound muscle action potentials (CMAP) evoked from frontal and orbicularis oris muscles. The active electrode was placed on the muscle belly, while reference electrode on the contralateral frontal muscle or on a chin. The electrical stimulation of facial nerve was applied at preauricular area (Fig. 2) [20]. The ground electrode was placed on the neck. Fig. 2


Correlations between the clinical, histological and neurophysiological examinations in patients before and after parotid gland tumor surgery: verification of facial nerve transmission.

Wiertel-Krawczuk A, Huber J, Wojtysiak M, Golusiński W, Pieńkowski P, Golusiński P - Eur Arch Otorhinolaryngol (2014)

Locations of surface stimulation and recording electrodes during CMAP examinations: A from frontal (a) and orbicularis oris (a) muscles and blink-reflex bilateral recordings; B from orbicularis oculi muscles in one of the healthy volunteers
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4372688&req=5

Fig2: Locations of surface stimulation and recording electrodes during CMAP examinations: A from frontal (a) and orbicularis oris (a) muscles and blink-reflex bilateral recordings; B from orbicularis oculi muscles in one of the healthy volunteers
Mentions: During ENG examinations time base was set on 5 ms/D, sensitivity of recordings on 2 mV/D. 10 Hz upper and 10 kHz lower filters of recorder amplifier were used. Standard (AgCl) surface electrodes were used for recording of compound muscle action potentials (CMAP) evoked from frontal and orbicularis oris muscles. The active electrode was placed on the muscle belly, while reference electrode on the contralateral frontal muscle or on a chin. The electrical stimulation of facial nerve was applied at preauricular area (Fig. 2) [20]. The ground electrode was placed on the neck. Fig. 2

Bottom Line: CMAP amplitudes after stimulation of mandibular marginal branch were reduced at about 25 % in patients with benign tumors after surgery.A similar trend was found for BR results.Needle EMG, ENG and BR examinations allow for the evaluation of face muscles reinnervation and facial nerve regeneration.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathophysiology of Locomotor Organs, Wiktor Dega Clinical Orthopaedic and Rehabilitation Hospital, University of Medical Sciences, 28 Czerwca 1956r. No 135/147, 61-545, Poznań, Poland, zpnr@wp.pl.

ABSTRACT
Parotid gland tumor surgery sometimes leads to facial nerve paralysis. Malignant more than benign tumors determine nerve function preoperatively, while postoperative observations based on clinical, histological and neurophysiological studies have not been reported in detail. The aims of this pilot study were evaluation and correlations of histological properties of tumor (its size and location) and clinical and neurophysiological assessment of facial nerve function pre- and post-operatively (1 and 6 months). Comparative studies included 17 patients with benign (n = 13) and malignant (n = 4) tumors. Clinical assessment was based on House-Brackmann scale (H-B), neurophysiological diagnostics included facial electroneurography [ENG, compound muscle action potential (CMAP)], mimetic muscle electromyography (EMG) and blink-reflex examinations (BR). Mainly grade I of H-B was recorded both pre- (n = 13) and post-operatively (n = 12) in patients with small (1.5-2.4 cm) benign tumors located in superficial lobes. Patients with medium size (2.5-3.4 cm) malignant tumors in both lobes were scored at grade I (n = 2) and III (n = 2) pre- and mainly VI (n = 4) post-operatively. CMAP amplitudes after stimulation of mandibular marginal branch were reduced at about 25 % in patients with benign tumors after surgery. In the cases of malignant tumors CMAPs were not recorded following stimulation of any branch. A similar trend was found for BR results. H-B and ENG results revealed positive correlations between the type of tumor and surgery with facial nerve function. Neurophysiological studies detected clinically silent facial nerve neuropathy of mandibular marginal branch in postoperative period. Needle EMG, ENG and BR examinations allow for the evaluation of face muscles reinnervation and facial nerve regeneration.

Show MeSH
Related in: MedlinePlus