Using the Post-Descendens Hypoglossal Nerve in Hypoglossal-Facial Anastomosis: An Anatomic and Histologic Feasibility Study

2020 ◽  
Vol 19 (4) ◽  
pp. 436-443
Author(s):  
Ali Tayebi Meybodi ◽  
Leandro Borba Moreira ◽  
Xiaochun Zhao ◽  
Evgenii Belykh ◽  
Michael T Lawton ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Hypoglossal Nerve ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Anatomic Study ◽  
Nerve Stump ◽  
Cross Sectional ◽  
Facial Nerves ◽  
Facial Reanimation ◽  
Structural Compatibility

Abstract BACKGROUND Hypoglossal-facial anastomosis (HFA) is a popular facial reanimation technique. Mobilizing the intratemporal segment of the facial nerve and using the post-descendens hypoglossal nerve (ie, the segment distal to the take-off of descendens hypoglossi) have been proposed to improve results. However, no anatomic study has verified the feasibility of this technique. OBJECTIVE To assess the anatomic feasibility of HFA and the structural compatibility between the 2 nerves when the intratemporal facial and post-descendens hypoglossal nerves are used. METHODS The facial and hypoglossal nerves were exposed bilaterally in 10 sides of 5 cadaveric heads. The feasibility of a side-to-end (ie, partial end-to-end) HFA with partial sectioning of the post-descendens hypoglossal nerve and the mobilized intratemporal facial nerve was assessed. The axonal count and cross-sectional area of the facial and hypoglossal nerves at the point of anastomosis were assessed. RESULTS The HFA was feasible in all specimens with a mean (standard deviation) 9.3 (5.5) mm of extra length on the facial nerve. The axonal counts and cross-sectional areas of the hypoglossal and facial nerves matched well. Considering the reduction in the facial nerve cross-sectional area after paralysis, the post-descendens hypoglossal nerve can provide adequate axonal count and area to accommodate the facial nerve stump. CONCLUSION Using the post-descendens hypoglossal nerve for side-to-end anastomosis with the mobilized intratemporal facial nerve is anatomically feasible and provides adequate axonal count for facial reanimation. When compared with use of the pre-descendens hypoglossal nerve, this technique preserves C1 fibers and has a potential to reduce glottic complications.

Interposition Grafting of the Facial Nerve After Resection of a Large Facial Nerve Schwannoma: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Walid Ibn Essayed ◽  
Emad Aboud ◽  
Ossama Al-Mefty
Keyword(s):  
Facial Nerve ◽  
Hypoglossal Nerve ◽  
Nerve Function ◽  
Nerve Paralysis ◽  
Carotid Canal ◽  
Great Auricular Nerve ◽  
Facial Nerves ◽  
Facial Reanimation ◽  
Graft Donor ◽  
Facial Nerve Schwannoma

Abstract Facial nerve schwannomas can develop at any portion of the facial nerve.1 When arising from the mastoid portion of the facial nerve, the tumor will progressively erode the mastoid, giving the schwannoma an aggressive radiological appearance.1,2 The facial nerve is frequently already paralyzed, or no fascicles can be saved during resection. In these cases, end-to-end interposition grafting is the best option for facial reanimation.1,3-5 The healthy proximal and distal facial nerves are prepared prior to grafting. The great auricular nerve is readily available near the surgical site and represents an excellent graft donor with minimal associated morbidity.4,6 We demonstrate this technique through a case of a 48-yr-old male who presented with a complete right-sided facial nerve palsy due to a large facial schwannoma that invaded the mastoid and extended to the hypoglossal canal, causing hypoglossal nerve paralysis, and petrous carotid canal. His 4-yr follow-up showed no recurrent tumor with restored facial nerve function palsy to a House-Brackman grade III, and full recovery of his hypoglossal nerve function. The patient consented to the surgery and the publication of his image.

Facial Nerve to Facial Canal Cross-Sectional Area Ratio in Children

1992 ◽  
Vol 102 (10) ◽  
pp. 1172-1176 ◽  
Author(s):  
Haruo Saito ◽  
Taizo Takeda ◽  
Seiji Kishimoto
Keyword(s):  
Facial Nerve ◽  
Area Ratio ◽  
Cross Sectional Area ◽  
Facial Canal ◽  
Sectional Area ◽  
Cross Sectional

scholarly journals Computer-Aided 3-D Reconstruction and Measurement of the Facial Canal and Facial Nerve. I. Cross-Sectional Area and Diameter

1993 ◽  
Vol 103 (10) ◽  
pp. 1150???1156 ◽  
Author(s):  
Shigeto Nakashima ◽  
Isamu Sando ◽  
Haruo Takahashi ◽  
Shuji Fujita
Keyword(s):  
Facial Nerve ◽  
Cross Sectional Area ◽  
Facial Canal ◽  
Sectional Area ◽  
Cross Sectional ◽  
Computer Aided

Ansa Cervicalis Stimulation Increases Pharyngeal Patency in Patients with Obstructive Sleep Apnea

2021 ◽  
Author(s):  
David T. Kent ◽  
William C. Scott ◽  
David Zealear ◽  
Alan R. Schwartz
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Hypoglossal Nerve ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Ansa Cervicalis ◽  
Obstructive Sleep ◽  
The Right ◽  
Stimulation Of

Rationale: Hypoglossal nerve stimulation (HNS) is an alternative treatment option for obstructive sleep apnea (OSA) that reduces pharyngeal collapsibility, but HNS non-responders often demonstrate continued retropalatal and lateral pharyngeal wall collapse. Recent evidence suggests that caudal pharyngeal traction with sternothyroid muscle contraction via ansa cervicalis stimulation (ACS) can also stabilize the pharynx, but the underlying mechanisms have not been elucidated. Objectives: To evaluate the effect of ACS on pharyngeal patency during expiration when the airway is most hypotonic. Methods: Eight participants with OSA underwent sustained ultrasound-guided fine-wire stimulation of the medial branch of the right hypoglossal nerve with and without transient stimulation of the branch of the ansa cervicalis nerve plexus innervating the right sternothyroid muscle during drug-induced sleep endoscopy. Airway cross-sectional area and expiratory airflow (VE) were measured from endoscopy video with ImageJ and pneumotachometry, respectively. Measurements and Main Results: ACS significantly increased retropalatal cross-sectional area (CSArp) to 211% [159-263] of unstimulated CSArp (p<0.05). Adding ACS to HNS increased CSArp from baseline by 341% [244-439] (p<0.05), a 180% [133-227] increase over isolated HNS (p<0.05). ACS increased VE from baseline by 177% [138-217] (p < 0.05). Adding ACS to HNS increased VE by 254% [207-301], reflecting decreases in pharyngeal collapsibility. Conclusions: Combining ACS with HNS increased retropalatal cross-sectional area and increased expiratory airflow, suggesting decreases in pharyngeal collapsibility. Our findings suggest that ACS exerts caudal traction on the upper airway through sternothyroid muscle contraction, and that it may augment HNS efficacy in patients with OSA.

The Masseteric-Facial Anastomosis With Intratemporal Translocation of the Facial Nerve: Step-by-Step Technique and Results

2021 ◽  
Author(s):  
Stefano Ferraresi ◽  
Elisabetta Basso ◽  
Lorenzo Maistrello ◽  
Piero Di Pasquale
Keyword(s):  
Facial Nerve ◽  
Emotional Response ◽  
Hypoglossal Nerve ◽  
Direct Transfer ◽  
Nerve Stump ◽  
Surgical Timing ◽  
Quality Of Results ◽  
Facial Reanimation ◽  
Masseteric Nerve

Abstract BACKGROUND In the absence of a viable proximal nerve stump, damaged after surgical procedures around the skull base, numerous techniques for facial reanimation have been developed over time, aiming to restore baseline symmetry and active mimicry. OBJECTIVE To report experience using the masseteric nerve as a direct transfer to the facial nerve rerouted after intratemporal translocation. This paper illustrates the main steps of the technique and the quality of results. METHODS Eleven patients were treated with a masseteric direct transfer to the facial nerve. Its extratemporal rerouting toward the zygoma allowed tension-free coaptation between donor and recipient nerves. RESULTS Of the 11 patients, 8 had a good to excellent recovery, showing different patterns of time and scores, according to age, surgical timing, and masseteric nerve function quality. The return of activity in the frontalis muscle, never obtained after reinnervation via the hypoglossal nerve, is of particular interest. The quality of the smile can be improved with re-education and practice but remains under volitional control. A true emotional response is still lacking. CONCLUSION The masseteric nerve is an excellent alternative to the hypoglossal nerve and can reinnervate the whole territory of the facial nerve rerouted after intratemporal translocation. The overall results are remarkable, but the low quality of the trigeminal nerve, eventually affected by the first surgery, may be an important limitation. Even if the patients appear more at ease in re-education than with other techniques, a fully natural facial expression remains impossible to obtain.

Pelvic Canal Narrowing Caused by Triple Pelvic Osteotomy in the Dog

1994 ◽  
Vol 07 (03) ◽  
pp. 110-113 ◽  
Author(s):  
D. L. Holmberg ◽  
M. B. Hurtig ◽  
H. R. Sukhiani
Keyword(s):  
Postoperative Complications ◽  
Pelvic Osteotomy ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Canal Width ◽  
Operative Complications ◽  
Post Operative Complications

SummaryDuring a triple pelvic osteotomy, rotation of the free acetabular segment causes the pubic remnant on the acetabulum to rotate into the pelvic canal. The resulting narrowing may cause complications by impingement on the organs within the pelvic canal. Triple pelvic osteotomies were performed on ten cadaver pelves with pubic remnants equal to 0, 25, and 50% of the hemi-pubic length and angles of acetabular rotation of 20, 30, and 40 degrees. All combinations of pubic remnant lengths and angles of acetabular rotation caused a significant reduction in pelvic canal-width and cross-sectional area, when compared to the inact pelvis. Zero, 25, and 50% pubic remnants result in 15, 35, and 50% reductions in pelvic canal width respectively. Overrotation of the acetabulum should be avoided and the pubic remnant on the acetabular segment should be minimized to reduce postoperative complications due to pelvic canal narrowing.When performing triple pelvic osteotomies, the length of the pubic remnant on the acetabular segment and the angle of acetabular rotation both significantly narrow the pelvic canal. To reduce post-operative complications, due to narrowing of the pelvic canal, overrotation of the acetabulum should be avoided and the length of the pubic remnant should be minimized.

DETERMINATION OF THE FUNCTION OF THE ROD’S CROSS-SECTIONAL AREA USING VIBRATION EIGENFREQUENCIES

2020 ◽  
Vol 0 (4) ◽  
pp. 19-24
Author(s):  
I.M. UTYASHEV ◽  
◽  
A.A. AITBAEVA ◽  
A.A. YULMUKHAMETOV ◽  
◽  
...  
Keyword(s):  
Cross Sectional Area ◽  
Variable Cross ◽  
Sectional Area ◽  
Longitudinal Vibrations ◽  
Cross Sectional ◽  
Method Error ◽  
Various Boundary Conditions ◽  
Elastic Fixation ◽  
Crosssectional Area

The paper presents solutions to the direct and inverse problems on longitudinal vibrations of a rod with a variable cross-sectional area. The law of variation of the cross-sectional area is modeled as an exponential function of a polynomial of degree n . The method for reconstructing this function is based on representing the fundamental system of solutions of the direct problem in the form of a Maclaurin series in the variables x and λ. Examples of solutions for various section functions and various boundary conditions are given. It is shown that to recover n unknown coefficients of a polynomial, n eigenvalues are required, and the solution is dual. An unambiguous solution was obtained only for the case of elastic fixation at one of the rod’s ends. The numerical estimation of the method error was made using input data noise. It is shown that the error in finding the variable crosssectional area is less than 1% with the error in the eigenvalues of longitudinal vibrations not exceeding 0.0001.

Changes in the parameters of nasal breathing and parameters of the upper respiratory tract during orthognathic operations in patients with II and III skeletal class of jaw anomalies

2020 ◽  
pp. 22-27
Author(s):  
S.Sh. Gammadaeva ◽  
M.I. Misirkhanova ◽  
A.Yu. Drobyshev
Keyword(s):  
Respiratory Tract ◽  
Nasal Cavity ◽  
Nasal Septum ◽  
Cross Sectional Area ◽  
Upper Respiratory Tract ◽  
Sectional Area ◽  
Nasal Breathing ◽  
Cross Sectional ◽  
Skeletal Class ◽  
Upper Respiratory

The study analyzed the functional parameters of nasal breathing, linear parameters of the nasal aperture, nasal cavity and nasopharynx, volumetric parameters of the upper airways in patients with II and III skeletal class of jaw anomalies before and after orthognathic surgery. The respiratory function of the nose was assessed using a rhinomanometric complex. According to rhinoresistometry data, nasal resistance and hydraulic diameter were assessed. According to the data of acoustic rhinometry, the minimum cross-sectional area along the internal valve, the minimum cross-sectional area on the head of the inferior turbinate and nasal septum and related parameters were estimated. According to the CBCT data, the state of the nasal septum, the inferior turbinates, the nasal aperture, the state of the nasal cavity, and the linear values of the upper respiratory tract (nasopharynx) were analyzed. The patients were divided into 4 groups according to the classification of the patency of the nasal passages by

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