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Lookup NU author(s): Professor Vinidh Paleri,
Dr Catherine Watson
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Objective: To objectively evaluate the usefulness and the reliability of the perineural vascular plexus as a landmark for identification of the facial nerve in surgery for chronic squamous otitis media. Study Design: Prospective case series. Setting: Tertiary otologic center. Patients: Seventy consecutive patients requiring surgery for cholesteatomatous otitis media. Intervention: Use of a semi quantitative grading system intraoperatively to assess the utility and ease of using the perineural facial plexus as the pointer to the facial nerve. Main Outcome Measures: Description of the perineural vascular plexus and assessment of the reproducibility of the grading system. Results: In 82.5% of patients, the plexus was used as the sole pointer to the level of the facial nerve, with other landmarks being used in the remaining 17.5%. A very prominent vessel was used to identify the nerve in 82.5%, therefore being classified as Grade 1. Multiple small vessels were seen in 15.8% (Grade 2), and in 1.5% the vessel plexus was thin and difficult to identify. The average measure intraclass correlation was 0.75 (95% confidence interval, 0.57-0.85), indicating excellent reproducibility of the system. Conclusion: We believe that the perineural vascular plexus is a dependable and reliable landmark for the level of the facial nerve in surgery for chronic otitis media.
Author(s): Paleri V, Watson C
Publication type: Article
Publication status: Published
Journal: Otology & Neurotology
ISSN (print): 1531-7129
ISSN (electronic): 1537-4505
Publisher: Lippincott Williams & Wilkins
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