P128. Can the extratemporal facial nerve been visualized by ultrasound?

Publication date: August 2018

Source: Clinical Neurophysiology, Volume 129, Issue 8

Author(s): G.F. Volk, J. Thielker, H. Wegscheider, O. Guntinas-Lichius, B. Moriggl

Introduction

Many peripheral nerves can be visualized by ultrasound for diagnostic and therapeutic interventions. The possibility of visualizing the facial nerve (FN) has been considered, but not jet proven scientifically. This study describes the first systematic evaluation of sonografic facial nerve vizualisation of the whole extratemporal facial nerv.

Methods

Eight cadaveric hemifaces were evaluated by means of high frequency ultrasound with two linear (13 MHz and 22 MHz) and a convex transducer (6.6 MHz), in order to detect the extratemporal course of the FN starting from its exit at the stylomastoid foramen: the main trunk, the parotid plexus between the two parts of the parotid gland (Image1), the distal branches terminating into the orbicularis oculi and the zygomatic major muscle. Ultrasound-guided color injections and FN dissection were performed to confirm the results (Image2).

Results

The main trunk of the FN, as it exits the stylomastoid foramen, was correctly stained in 75%, the parotid plexus in 100%. The branches innervating the orbicularis oculi muscle were stained in 100% and the branches innervating the zygomatic major muscle in 86% hemifaces, after 1 was withdrawn due to insufficient image quality.

Conclusions

Through our novel approach of high-resolution ultrasonography we could identify the various portions of the extratemporal FN, including its main trunk leaving the stylomastoid foramen, in an accurate and reproducible way. This might be a way to visualize and locate nerve damage.

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