Imaging of Facial Nerve With 3D-DESS-WE-MRI Before Parotidectomy: Impact on Surgical Outcomesopen access
- Authors
- Jeong, H.-S.[Jeong, Han-Sin]; Kim, Y.[Kim, Yikyung]; Kim, H.-J.[Kim, Hyung-Jin]; Kim, H.J.[Kim, Hak Jung]; Kim, E.-H.[Kim, Eun-Hye]; Woo, S.-Y.[Woo, Sook-Young]; Chung, M.K.[Chung, Man Ki]; Son, Y.-I.[Son, Young-Ik]
- Issue Date
- 1-Sep-2023
- Publisher
- Korean Radiological Society
- Keywords
- Facial nerve; Magnetic resonance imaging; Parotid neoplasms; Propensity score; Prospective studies
- Citation
- Korean Journal of Radiology, v.24, no.9, pp.860 - 870
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- Korean Journal of Radiology
- Volume
- 24
- Number
- 9
- Start Page
- 860
- End Page
- 870
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/108023
- DOI
- 10.3348/kjr.2022.0850
- ISSN
- 1229-6929
- Abstract
- Objective: The intra-parotid facial nerve (FN) can be visualized using three-dimensional double-echo steady-state water-excitation sequence magnetic resonance imaging (3D-DESS-WE-MRI). However, the clinical impact of FN imaging using 3D-DESS-WE-MRI before parotidectomy has not yet been explored. We compared the clinical outcomes of parotidectomy in patients with and without preoperative 3D-DESS-WE-MRI. Materials and Methods: This prospective, non-randomized, single-institution study included 296 adult patients who underwent parotidectomy for parotid tumors, excluding superficial and mobile tumors. Preoperative evaluation with 3D-DESS-WE-MRI was performed in 122 patients, and not performed in 174 patients. FN visibility and tumor location relative to FN on 3D-DESS-WE-MRI were evaluated in 120 patients. Rates of FN palsy (FNP) and operation times were compared between patients with and without 3D-DESS-WE-MRI; propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used to adjust for surgical and tumor factors. Results: The main trunk, temporofacial branch, and cervicofacial branch of the intra-parotid FN were identified using 3D-DESS-WE-MRI in approximately 97.5% (117/120), 44.2% (53/120), and 25.0% (30/120) of cases, respectively. The tumor location relative to FN, as assessed on magnetic resonance imaging, concurred with surgical findings in 90.8% (109/120) of cases. Rates of temporary and permanent FNP did not vary between patients with and without 3D-DESS-WE-MRI according to PSM (odds ratio, 2.29 [95% confidence interval {CI} 0.64–8.25] and 2.02 [95% CI: 0.32–12.90], respectively) and IPTW (odds ratio, 1.76 [95% CI: 0.19–16.75] and 1.94 [95% CI: 0.20–18.49], respectively). Conversely, operation time for surgical identification of FN was significantly shorter with 3D-DESS-WE-MRI (median, 25 vs. 35 min for PSM and 25 vs. 30 min for IPTW, P < 0.001). Conclusion: Preoperative FN imaging with 3D-DESS-WE-MRI facilitated anatomical identification of FN and its relationship to the tumor during parotidectomy. This modality reduced operation time for FN identification, but did not significantly affect postoperative FNP rates. © 2023 The Korean Society of Radiology.
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