title: A Technique for Preoperative Identification of the Facial Nerve Mandibular Branch Using a Nerve Stimulator.
abstract: We established the method of preoperative identification to facial nerve marginal mandibular branch (FNMB) identification using a nerve stimulator with bipolar probe for upper-neck surgery. The bipolar electrode is placed on the region while patients were awake; the patient should be in the same position and posture as during the surgery, with the neck skin stretched. A nerve course is confirmed by observing the movement of the lower lip. In this study, 5 upper-neck surgeries were conducted. Preoperative analysis revealed that 4 of the 5 cases had 2 branches of FNMB, and 1 with 3 branches. All FNMB immediately confirmed preoperatively were identified during surgery. We performed this method in much surgery including the surgery of the upper neck. It was easy to identify the facial nerve by this method and came to be able to do it precisely, and an operative time was shortened. We concluded that the preoperative FNMB identification using a nerve stimulator is most useful and benefit for upper-neck surgery patients and lead to avoid lower lip paralysis.
authors.affiliation: *Department of Otolaryngology-Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya †Department of Oral and Maxillofacial Surgery, Asahi University Murakami Memorial Hospital, Gifu, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Ijichi
authors.forename: Makoto
authors.initials: M
authors.lastname: Adachi
authors.forename: Yuki
authors.initials: Y
authors.lastname: Hamajima
authors.forename: Shingo
authors.initials: S
authors.lastname: Murakami
mesh_terms: D000328:Adult; D004558:Electric Stimulation / Q000295:instrumentation*; D005154:Facial Nerve / Q000033:anatomy & histology* / Q000502:physiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery; D006391:Hemangioma / Q000601:surgery; D006801:Humans; D008046:Lip / Q000294:innervation; D008047:Lip Diseases / Q000517:prevention & control; D008297:Male; D008340:Mandibular Nerve / Q000033:anatomy & histology* / Q000502:physiology; D008875:Middle Aged; D009333:Neck / Q000601:surgery*; D037981:Neck Dissection / Q000379:methods; D061886:Neuromuscular Monitoring / Q000295:instrumentation; D061646:Operative Time; D010243:Paralysis / Q000517:prevention & control; D011300:Preoperative Care