Background: The masseteric nerve is one of the main options to neurotize free muscle flaps in irreversible long-term facial paralysis. Several preoperative skin-marking techniques for the masseteric nerve have been proposed to limit the surgical dissection area, shorten the surgical time, and enable a safer dissection. However, these have shown variability among them, and cannot visualize the nerve preoperatively. The authors designed an observational study to validate a high-frequency ultrasound (HFUS) nerve identification technique.
Methods: A systematic HFUS examination was designed and performed to visualize the masseteric nerve in 64 hemifaces of healthy volunteers. One-third were randomly selected to undergo an additional HFUS-guided needle electrostimulation to validate the HFUS image.
Results: The masseteric nerve was identified by HFUS in 96.9% of hemifaces (95% CI, 0.89 to >0.99) and showed almost perfect agreement with direct needle stimulation as calculated with Cohen kappa coefficient (0.95; 95% CI, 0.85 to 1.00). The masseteric nerve was found within the masseter muscle, in between the deeper muscle bellies, at 18.3 mm (SD ±2.2) from the skin. Only in 12.9% of cases (95% CI, 0.06 to 0.24) did its course become adjacent to the mandible periosteum. Other important features, such as disposition in relation to the parotid gland, or if the nerve was covered directly by a thick intramuscular aponeurosis, could be well observed by HFUS.
Conclusion: HFUS enables masseteric nerve identification and can provide the surgeon with specific information on anatomical relations for each examined individual before surgery.
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http://dx.doi.org/10.1097/PRS.0000000000010871 | DOI Listing |
Stomatologiia (Mosk)
December 2024
Russian University of Medicine of Healthcare Ministry of Russia, Moscow, Russia.
The Aim Of The Study: To determine the type of electric current with the greatest diagnostic value used to study the electrical sensitivity of teeth in inferior alveolar nerve neuritis.
Materials And Methods: We examined 32 patients aged from 22 to 57 years, in whom neuritis of the inferior alveolar nerve developed due to traumatic removal of the lower third molar. There were 14 females and 18 males.
Pak J Med Sci
December 2024
Prof. Dr. Asif Bashir, Professor, Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore, Pakistan.
Objective: Multiple techniques have been used to treat trigeminal neuralgia (TGN), including pharmacotherapy, radiosurgery, rhizotomy and microvascular decompression (MVD). Blood vessels are considered to be the most common cause of offense and compression to trigeminal nerve. We aimed to determine the causes of classic TGN and efficacy of MVD.
View Article and Find Full Text PDFJPRAS Open
March 2025
Department of Surgery, Marien Hospital Herne, University Hospital of Ruhr University Bochum, Herne, NRW, Germany.
Background: Despite extensive discourse on the utilisation of the temporal muscle for facial reanimation, anatomical description regarding the innervation of its motor nerve branches is incomplete and varied. This systematic review aimed to consolidate the existing evidence concerning the distribution and variation in the pattern of temporalis innervation.
Methods: A PRISMA-compliant systematic literature search was conducted in November 2023 and included studies offering anatomical insights into the distribution and variation of temporalis innervation patterns.
Ann Vasc Surg
December 2024
Department of General and Vascular Surgery, National Medical Institute of the Ministry of the Interior and Administration; 2nd Department of Vascular Surgery and Angiology, CMKP.
Background: Extracranial carotid artery aneurysm (ExCAA) is a very rare pathology. However, due to local compression symptoms, risk of CNS ischemia, and the potential risk of rupture, it constitutes a significant clinical problem. The small number of cases, substantial differences in etiology and morphology, and various treatment methods of ExCAA disturb the analysis of this pathology.
View Article and Find Full Text PDFDent Med Probl
December 2024
Chair of Practical Clinical Dentistry, Department of Diagnostics, Poznan University of Medical Sciences, Poland.
Background: The inferior alveolar canal (IAC) is a fundamental mandibular structure. It is important to conduct a precise pre-surgical evaluation of the IAC to prevent complications. Recently, the use of artificial intelligence (AI) has demonstrated potential as a valuable tool for dentists, particularly in the field of oral and maxillofacial radiology.
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