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Preoperative percutaneous facial nerve mapping

Plastic and Reconstructive Surgery

|February 14, 1998

Summary

Facial plastic surgeons can now precisely map the facial nerve's peripheral branches before surgery. This new percutaneous facial nerve mapping (PFNM) technique enhances surgical safety and precision.

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Area of Science:

Plastic Surgery
Facial Anatomy
Nerve Surgery

Background:

Peripheral facial nerve branches, especially the marginal mandibularis, are susceptible to injury during various facial surgeries.
Current surgical techniques primarily focus on avoiding potential nerve locations rather than precise pre-operative identification.
Lack of pre-operative methods to locate facial nerve branches increases surgical risks.

Purpose of the Study:

To introduce a novel method for pre-operative, percutaneous identification and mapping of peripheral facial nerve branches.
To enhance surgical planning and safety in facial procedures involving the marginal mandibular nerve.
To enable surgeons to make more informed decisions regarding incision placement and tissue dissection.

Main Methods:

Development of a percutaneous facial nerve mapping (PFNM) technique.
Pre-operative identification and visualization of the course of peripheral facial nerve branches.
Application of PFNM in a series of 57 surgical cases since August 1994.

Main Results:

The PFNM technique successfully mapped the course of peripheral facial nerve branches in most studied patients.
The mapping allowed surgeons to select more favorable incision locations.
Dissection adjacent to the facial nerve could be performed more safely and aggressively when necessary.

Conclusions:

Percutaneous facial nerve mapping (PFNM) provides a valuable tool for pre-operative visualization of facial nerve anatomy.
This technique improves surgical precision and safety, particularly in procedures involving the marginal mandibular nerve.
PFNM facilitates more confident and potentially aggressive dissection in critical areas, reducing the risk of nerve injury.

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