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08.05.2024 | Head-Neck-ENT Radiology

MR-Neurography of the facial nerve in parotid tumors: intra-parotid nerve visualization and surgical correlation

verfasst von: Chiara Gaudino, Andrea Cassoni, Martina Lucia Pisciotti, Resi Pucci, Angela Palma, Nicoletta Fantoni, Patrizia Pantano, Valentino Valentini

Erschienen in: Neuroradiology

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Abstract

Purpose

One of the most severe complications in surgery of parotid tumors is facial palsy. Imaging of the intra-parotid facial nerve is challenging due to small dimensions. Our aim was to assess, in patients with parotid tumors, the ability of high-resolution 3D double-echo steady-state sequence with water excitation (DE3D-WE) (1) to visualize the extracranial facial nerve and its tracts, (2) to evaluate their relationship to the parotid lesion and (3) to compare MRI and surgical findings.

Methods

A retrospective study was conducted including all patients with parotid tumors, who underwent MRI from April 2022 to December 2023. Two radiologists independently reviewed DE3D-WE images, assessing quality of visualization of the facial nerve bilaterally and localizing the nerve’s divisions in relation to the tumor. MRI data were compared with surgical findings.

Results

Forty consecutive patients were included (M:F = 22:18; mean age 56.3 ± 17.4 years). DE3D-WE could excellently visualize the nerve main trunk and the temporofacial division in all cases. The cervicofacial branch was visible in 99% of cases and visibility was good. Distal divisions were displayed in 34% of cases with a higher visibility on the tumor side (p < 0.05). Interrater agreement was high (weighted kappa 0.94 ± 0.01 [95% CI 0.92–0.97]).

Compared to surgery accuracy of MRI in localizing the nerve was 100% for the main trunk, 96% for the temporofacial and 89% for the cervicofacial branches.

Conclusions

Facial nerve MR-neurography represents a reliable tool. DE3D-WE can play an important role in surgical planning of patients with parotid tumors, reducing the risk of nerve injury.

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Titel: MR-Neurography of the facial nerve in parotid tumors: intra-parotid nerve visualization and surgical correlation
verfasst von: Chiara Gaudino
Andrea Cassoni
Martina Lucia Pisciotti
Resi Pucci
Angela Palma
Nicoletta Fantoni
Patrizia Pantano
Valentino Valentini
Publikationsdatum: 08.05.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: Neuroradiology
Print ISSN: 0028-3940
Elektronische ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-024-03372-5

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