Does Evoked Electromyography Detect the Injured Facial Nerve Recovery Earlier Than Clinical Assessments?


Journal

Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
ISSN: 1531-5053
Titre abrégé: J Oral Maxillofac Surg
Pays: United States
ID NLM: 8206428

Informations de publication

Date de publication:
05 2022
Historique:
received: 30 06 2021
revised: 13 12 2021
accepted: 15 12 2021
pubmed: 19 1 2022
medline: 20 4 2022
entrez: 18 1 2022
Statut: ppublish

Résumé

The key element in managing postoperative facial nerve (FN) injuries is timely diagnosis and intervention as indicated. The purpose of this study was to measure and compare evoked electromyography (EEMG) and clinical assessment in terms of the recovery of the injured FN in operated temporomandibular joint ankylosis (TMJA) cases. The investigators designed a prospective cohort study in the primary operated TMJA patients. The primary predictor variable was the technique used to assess FN function, House-Brackmann Facial Nerve Grading System (HBFNGS) or EEMG. The primary outcome variable was time to FN recovery. The FN recovery was assessed in different time points (1 week, 1 month, 3 months, and 6 months). Age, gender, side (unilateral/bilateral), type of ankylosis (Sawhney's classification), and operating time were kept as covariates. Categorical variables were analyzed using Fisher's exact test. Multilevel survival analysis was performed considering the subject as cluster to perform Kaplan-Meier analysis and compute the hazards ratio using the Cox-regression method with adjustment for covariates. P <0.05 was set as statistically significant. The study sample composed of 43 (69 sides) TMJA cases who underwent surgery developed iatrogenic FN injury in 10 cases (14 sides [9 right; 5 left]). The incidence of FN injury was 20.3% (14/69). Sawhey's type III/type IV ankylosis and the operating time for more than 2 hours showed a statistically significant (p<0.05) increase in FN injury. The mean duration to detect FN recovery by EEMG was 9 days (95% confidence interval, 5 to 12 days), but the HBFNGS took 161 days (95% confidence interval, 141 to 181 days). The chance of early detection by EEMG was 18.6 times more than the chance by the HBFNGS (Cox-hazard ratio, 18.6). To conclude, EEMG is a noninvasive and reliable tool that detects FN recovery much earlier than the HBFNGS in the postoperative TMJA cases.

Identifiants

pubmed: 35041808
pii: S0278-2391(21)01514-7
doi: 10.1016/j.joms.2021.12.010
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

814-821

Informations de copyright

Copyright © 2021 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Auteurs

Anjali Virkhare (A)

Former Junior Resident, Department of Oral & Maxillofacial surgery, All India Institute of Medical Sciences, New Delhi, India.

Saravanan Lakshmanan (S)

Senior Resident, Department of Oral & Maxillofacial surgery, All India Institute of Medical Sciences, New Delhi, India.

Ongkila Bhutia (O)

Professor, Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India. Electronic address: dr_ongkila@rediffmail.com.

Ajoy Roychoudhury (A)

Professor and Head, Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India.

Nalin Mehta (N)

Professor, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.

Shivam Pandey (S)

Scientist - I, Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH