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Predicting postoperative facial nerve paralysis by using intraoperative nerve monitoring during parotid surgery

  • Head and Neck
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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objectives

To investigate a method for predicting postoperative facial nerve paralysis (POFNP) during parotid surgery using intraoperative nerve monitoring (IONM).

Methods

We assessed prediction for POFNP by using IONM, comparing between stimulation in the facial nerve trunk and each branch by using facial nerve monitoring. The amplitude response ratio (ARR) was calculated for the trunk/periphery. In addition, we then examined the correlation between ARR and time to recovery of paralyzed branches.

Results

372 branches of 93 patients did not develop POFNP and were classified as group A. Among 20 patients who developed POFNP, 51 branches without POFNP were classified as group B, and 29 branches with POFNP were classified as group C. The ARR was approximately 1 in group A and B. but less than 0.5 in all branches in Group C. When the cut off value of ARR was set at 0.55, the sensitivity, specificity, and accuracy of POFNP diagnosis by ARR were 96.5%, 93.1%, and 96.8%, respectively.

Conclusion

Using IONM during parotid surgery enables easy prediction of POFNP.

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Data Availability

Raw data were generated at Osaka Medical and Pharmaceutical University. Derived data supporting the findings of this study are available from the corresponding author, Masaaki Higashino, on request.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan

    Masaaki Higashino, Ichita Kinoshita, Tsuyoshi Jinnin, Tetsuya Terada & Ryo Kawata

Authors
  1. Masaaki Higashino
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  2. Ichita Kinoshita
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  3. Tsuyoshi Jinnin
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  4. Tetsuya Terada
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  5. Ryo Kawata
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Contributions

MH designed the study. MH, IK, TJ, and TT acquired all data. M.H. wrote the manuscript. RK supervised the study. All authors performed data analysis and interpretation and approved the manuscript.

Corresponding author

Correspondence to Masaaki Higashino.

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The authors declare that they have no conflicts of interest.

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Higashino, M., Kinoshita, I., Jinnin, T. et al. Predicting postoperative facial nerve paralysis by using intraoperative nerve monitoring during parotid surgery. Eur Arch Otorhinolaryngol 280, 3855–3860 (2023). https://doi.org/10.1007/s00405-023-07973-3

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  • DOI: https://doi.org/10.1007/s00405-023-07973-3

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