Imaging Sci Dent.
2022 Sep;52(3):259-266. 10.5624/isd.20220035.
Clinical validation of the 3-dimensional double-echo steady-state with water excitation sequence of MR neurography for preoperative facial and lingual nerve identification
- Affiliations
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- 1Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
- 2Department of Oral and Maxillofacial Surgery, Samsung Medical Center, Seoul, Korea
- 3Department. of Oral and Maxillofacial Radiology, College of Dentistry, Yonsei University, Seoul, Korea
- KMID: 2533455
- DOI: http://doi.org/10.5624/isd.20220035
Abstract
- Purpose
This study aimed to evaluate the clinical usefulness of magnetic resonance (MR) neurography using the 3-dimensional double-echo steady-state with water excitation (3D-DESS-WE) sequence for the preoperative delineation of the facial and lingual nerves.
Materials and Methods
Patients underwent MR neurography for a tumor in the parotid gland area or lingual neuropathy from January 2020 to December 2021 were reviewed. Preoperative MR neurography using the 3D-DESS-WE sequence was evaluated. The visibility of the facial nerve and lingual nerve was scored on a 5-point scale, with poor visibility as 1 point and excellent as 5 points. The facial nerve course relative to the tumor was identified as superficial, deep, or encased. This was compared to the actual nerve course identified during surgery. The operative findings in lingual nerve surgery were also described.
Results
Ten patients with parotid tumors and 3 patients with lingual neuropathy were included. Among 10 parotid tumor patients, 8 were diagnosed with benign tumors and 2 with malignant tumors. The median facial nerve visibility score was 4.5 points. The distribution of scores was as follows: 5 points in 5 cases, 4 points in 1 case, 3 points in 2 cases, and 2 points in 2 cases. The lingual nerve continuity score in the affected area was lower than in the unaffected area in all 3 patients. The average visibility score of the lingual nerve was 2.67 on the affected side and 4 on the unaffected side.
Conclusion
This study confirmed that the preoperative localization of the facial and lingual nerves using MR neurography with the 3D-DESS-WE sequence was feasible and contributed to surgical planning for the parotid area and lingual nerve.
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