Issue release date: 12.11.2024

 
Turkish Neurosurgery 2023 , Vol 33 , Num 1
CT-Based Intraoperative Navigation for Quick Identification of the Stylomastoid Foramen During Hypoglossal-Facial Nerve Anastomosis
Anna Maria AURICCHIO1,Quintino Giorgio D'ALESSANDRIS1,Pier Paolo MATTOGNO1,Eduardo Marcos FERNANDEZ MARQUEZ1,Liverana LAURETTI1
1Department of Neurosurgery, Fondazione Policlinico Universitario ?A. Gemelli? IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Roma, Italy DOI : 10.5137/1019-5149.JTN.37301-21.2 AIM: To present the ability of standard intraoperative neuronavigation to reliably identify the stylomastoid foramen, thus providing a quick and effective recognition of the facial nerve at its exit from the skull base.

MATERIAL and METHODS: We describe the technical nuances of this procedure by presenting two surgical cases who underwent hypoglossal-facial nerve anastomosis for complete facial nerve palsy occurring post removal of a giant vestibular schwannoma 6 months earlier.

RESULTS: CT-based neuronavigation allowed a quick and reliable identification of the stylomastoid foramen and of the facial nerve at its exit from the skull. The entire procedure lasted for 3 hours. Three months after the anastomosis, the first signs of facial muscle reinnervation were visible.

CONCLUSION: The use of neuronavigation during hypoglossal-facial nerve anastomosis is a simple and cost-effective strategy to decrease operative duration and increase surgical effectiveness. Keywords : Hypoglossal-facial nerve anastomosis, Stylomastoid foramen, Facial nerve palsy, Navigation

Corresponding author : Anna Maria AURICCHIO, anna.maria.90a@libero.it