9802-269 Park
Park JI.
Preoperative percutaneous facial nerve mapping.
Plast Reconstr Surg. 1998 Feb;101(2):269-77. PMID: 9462757
Comment in:
Plast Reconstr Surg. 1999 Apr;103(4):1322-4.
Peripheral branches of the facial nerve, the marginal mandibularis in
particular, are vulnerable to injury during facial surgery, i.e., submandibular
gland surgery, flap development in radical neck dissection, liposuction of the
jowl area, percutaneous insertion of a screw for mandibular plating, especially
at the angle of the mandible, and elevation of the superficial
musculoaponeurotic system (SMAS) in rhytidectomy. There is no technique
available to locate the peripheral branch of the facial nerve preoperatively so
that the area containing the nerve branch can be avoided in making an incision
or in developing a tissue plane. Unlike the otoneurological or neurosurgical
procedures, the facial nerve branches are not actively explored in facial
plastic surgery. Instead, the purpose of many techniques developed in the past
is to avoid dissecting an area where the nerve might be located. The author
developed a new method that can preoperatively and percutaneously identify and
map the course of the peripheral branch of the facial nerve. Percutaneous facial
nerve mapping (PFNM) allows a surgeon to make his or her incision in a more
favorable location, as the exact course of the facial nerve is already
visualized by the mapping technique. A tissue plane adjacent to a facial nerve
can be dissected more safely and aggressively, where and whenever necessary. Of
57 cases studied since August of 1994, the mapping was possible in most
patients, except for earlier cases in a developmental stage.
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