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Intra-parotid facial nerve path by MRI tractography: radio-clinical comparison in parotid tumors

  • Head and Neck
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Abstract

Purpose

The objective of our study was to evaluate the ability of preoperative MRI tractography to visualize and predict the path of the facial nerve with respect to an intra-parotid mass.

Methods

We performed an observational bicentric study from June 2019 to August 2020. All patients older than 18 years old, treated for a parotid mass with surgical indication, without MRI contraindication and who agreed to participate in the study were enrolled prospectively. All patients underwent a cervico-facial MRI with tractographic analysis. Postprocessed tractography images of the intra-parotid facial nerve were analyzed by two expert radiologists in head and neck imaging. The intraoperative anatomical description of the facial nerve path and its relationship to the mass was performed by the surgeon during the operation, with no visibility on MRI examination results. A statistical study allowed for the description of the data collected as well as the measurement of inter-observer agreement and agreement between tractography and surgery using kappa coefficients.

Results

Fifty-two patients were included. The facial nerve trunk and its first two divisional branches were visualized via tractography in 93.5% of cases (n = 43). The upper distal branches were visualized in 51.1% of cases (n = 23), and the lower branches were visualized in 73.3% of cases (n = 33). Agreement with the location described per-operatively was on average 82.9% for the trunk, 74.15% for the temporal branch, and 75.21% for the cervico-facial branch.

Conclusion

Fiber tractography analysis by MRI of the intra-parotid facial nerve appears to be a good test for predicting the path of the nerve over the parotid mass and could be an additional tool to guide the surgeon in the operative procedure.

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Acknowledgements

The authors would like to thank the Neuromédia association and the Head and Neck pole of the University Hospital of Reims for its financial support. The authors would also like to thank Dr Jonathan Attali for his help in MRI analysis.

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Authors and Affiliations

  1. Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France

    Axelle Thierry, Marc Labrousse, Marc Makeieff, Jean-Claude Merol, France Truong, Xavier Dubernard & Esteban Brenet

  2. University of Reims-Champagne Ardennes, Reims, France

    Axelle Thierry, Marc Labrousse, Marc Makeieff, France Truong, Xavier Dubernard & Esteban Brenet

  3. University Department of Health Research, University of Reims Champagne Ardennes, Reims, France

    Coralie Barbe & Aline Carsin-Vu

  4. Department of Radiology, University Hospital of Reims, Reims, France

    Axelle Thierry, Coralie Barbe, Marc Labrousse, Marc Makeieff, Jean-Claude Merol, Aline Carsin-Vu, France Truong, Xavier Dubernard & Esteban Brenet

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  1. Axelle Thierry
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  2. Coralie Barbe
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Correspondence to Esteban Brenet.

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Thierry, A., Barbe, C., Labrousse, M. et al. Intra-parotid facial nerve path by MRI tractography: radio-clinical comparison in parotid tumors. Eur Arch Otorhinolaryngol 281, 925–934 (2024). https://doi.org/10.1007/s00405-023-08301-5

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  • DOI: https://doi.org/10.1007/s00405-023-08301-5

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