title: Rapid and accurate identification of cut ends of facial nerves using a nerve monitoring system during surgical exploration and anastomosis.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Resident, Department of Oral and Craniomaxillofacial Science, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China.
authors.forename: Jiewen
authors.initials: J
authors.lastname: Dai
authors.forename: Steve Guofang
authors.initials: SG
authors.lastname: Shen
authors.forename: Shilei
authors.initials: S
authors.lastname: Zhang
authors.forename: Xudong
authors.initials: X
authors.lastname: Wang
authors.forename: Wenbin
authors.initials: W
authors.lastname: Zhang
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods*; D002610:Cheek / Q000294:innervation; D004210:Dissection / Q000379:methods; D004576:Electromyography / Q000295:instrumentation; D005151:Facial Injuries / Q000601:surgery; D005152:Facial Muscles / Q000294:innervation; D005154:Facial Nerve / Q000503:physiopathology / Q000601:surgery*; D020220:Facial Nerve Injuries / Q000601:surgery*; D005158:Facial Paralysis / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008340:Mandibular Nerve / Q000601:surgery; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods*; D061646:Operative Time; D010808:Physical Examination; D020127:Recovery of Function / Q000502:physiology; D013703:Temporal Muscle / Q000294:innervation; D016896:Treatment Outcome; D061221:Trigeminal Nerve Injuries / Q000601:surgery; D055815:Young Adult; D015050:Zygoma / Q000294:innervation