3D-Ultrasonography for evaluation of facial muscles in patients with chronic facial palsy or defective healing: a pilot study

BMC Ear, Nose and Throat Disorders

Orlando Guntinas-Lichius²  Heather J Chalmers¹  Mira Finkensieper²  Martin Pohlmann²  Gerd Fabian Volk² 

[1] Department of Clinical Sciences, Ontario Veterinary College, University of Guelph, 50 McGilvray St.Guelph, Guelph, ON N1G 2 W1, Canada;Department of Otorhinolaryngology, Jena University Hospital, Lessingstrasse 2, D-07740 Jena, Germany

关键词: Facial palsy;    Facial nerve;    Reconstructive surgery;    Facial musculature;    3D-Sonography;   

Others  :  862662
DOI  :  10.1186/1472-6815-14-4

 received in 2013-09-12, accepted in 2014-04-15,  发布年份 2014

【 摘 要 】

Background

While standardized methods are established to examine the pathway from motorcortex to the peripheral nerve in patients with facial palsy, a reliable method to evaluate the facial muscles in patients with long-term palsy for therapy planning is lacking.

Methods

A 3D ultrasonographic (US) acquisition system driven by a motorized linear mover combined with conventional US probe was used to acquire 3D data sets of several facial muscles on both sides of the face in a healthy subject and seven patients with different types of unilateral degenerative facial nerve lesions.

Results

The US results were correlated to the duration of palsy and the electromyography results. Consistent 3D US based volumetry through bilateral comparison was feasible for parts of the frontalis muscle, orbicularis oculi muscle, depressor anguli oris muscle, depressor labii inferioris muscle, and mentalis muscle. With the exception of the frontal muscle, the facial muscles volumes were much smaller on the palsy side (minimum: 3% for the depressor labii inferior muscle) than on the healthy side in patients with severe facial nerve lesion. In contrast, the frontal muscles did not show a side difference. In the two patients with defective healing after spontaneous regeneration a decrease in muscle volume was not seen. Synkinesis and hyperkinesis was even more correlated to muscle hypertrophy on the palsy compared with the healthy side.

Conclusion

3D ultrasonography seems to be a promising tool for regional and quantitative evaluation of facial muscles in patients with facial palsy receiving a facial reconstructive surgery or conservative treatment.

【 授权许可】

   
2014 Volk et al.; licensee BioMed Central Ltd.

【 图 表 】

【 参考文献 】

• [1]Guntinas-Lichius O, Streppel M, Stennert E: Postoperative functional evaluation of different reanimation techniques for facial nerve repair. Am J Surg 2006, 191:61-67.
• [2]Volk GF, Pantel M, Guntinas-Lichius O: Modern concepts in facial nerve reconstruction. Head Face Med 2011, 6:25.
• [3]Terzis JK, Konofaos P: Nerve transfers in facial palsy. Facial Plast Surg 2008, 24:177-193.
• [4]Finkensieper M, Volk GF, Guntinas-Lichius O: Facial nerve disorders. Laryngo-Rhino-Otologie 2012, 91:121-141. quiz 142
• [5]Kaylie DM, Wax MK, Weissman JL: Preoperative facial muscle imaging predicts final facial function after facial nerve grafting. Am J Neuroradiol 2003, 24:326-330.
• [6]Arts IM, Overeem S, Pillen S, Schelhaas HJ, Zwarts MJ: Muscle changes in amyotrophic lateral sclerosis: a longitudinal ultrasonography study. Clin Neurophysiol 2011, 122:623-628.
• [7]Min L, Lai G, Xin L: Changes in masseter muscle following curved ostectomy of the prominent mandibular angle: an initial study with real-time 3D ultrasonograpy. J Oral Maxillofac Surg 2008, 66:2434-2443.
• [8]Balogh B, Fruhwald F, Millesi W, Millesi H, Firbas W: Sonoanatomy of the muscles of facial expression. Surg Radiol Anat 1988, 10:101-106.
• [9]Volk GF, Wystub N, Pohlmann M, Finkensieper M, Chalmers HJ, Guntinas-Lichius O: Quantitative ultrasonography of facial muscles. Muscle Nerve 2013, 47:878-883.
• [10]Grosheva M, Wittekindt C, Guntinas-Lichius O: Prognostic value of electroneurography and electromyography in facial palsy. Laryngoscope 2008, 118:394-397.
• [11]Guntinas-Lichius O, Angelov DN, Stennert E, Neiss WF: Delayed hypoglossal-facial nerve suture after predegeneration of the peripheral facial nerve stump improves the innervation of mimetic musculature by hypoglossal motoneurons. J Comp Neurol 1997, 387:234-242.
• [12]Gordon T, Tyreman N, Raji MA: The basis for diminished functional recovery after delayed peripheral nerve repair. J Neurosci 2011, 31:5325-5334.
• [13]Kaylie DM, Jackson CG, Aulino JM, Gardner EK, Weissman JL: Preoperative appearance of facial muscles on magnetic resonance predicts final facial function after acoustic neuroma surgery. Otol Neurotol 2004, 25:622-626.