Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons · 2025
Can Evoked Electromyography Detect Postoperative Facial Nerve Recovery Earlier Than Grading Scales Following Temporomandibular Joint Ankylosis Surgery?
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Basnet Abiskar, Simre Saurabh, Chug Ashi, Kumar Rathod Prem, Mahajan Aparna, Kulshrestha Poorvi
Аннотация
BACKGROUND: Facial nerve (FN) dysfunction is a potential postoperative complication of managing temporomandibular joint ankylosis (TMJa).
PURPOSE: The purpose of this study was to determine whether evoked electromyography (EEMG) detects postoperative FN function (FNF) recovery earlier than House-Brackmann scale (HBS) and Sunnybrook scale (SBS) following TMJa surgery.
STUDY DESIGN, SETTING, SAMPLE: A prospective, single tertiary-care center cohort study was conducted at All India Institute of Medical Sciences, Rishikesh from October 2022 to April 2024. Patients with unilateral TMJa aged above 12 years were included. Exclusion criteria were previous surgery of parotid/temporomandibular joint, preexisting FN palsy, neuromuscular disorders, syndromic patients.
PREDICTOR VARIABLE: The primary predictor variable was FNF recovery monitoring tool (EEMG vs HBS vs SBS).
MAIN OUTCOME VARIABLES: The primary outcome variable was FNF recovery time. This was recorded postoperatively at defined time-points (1 week-T1, 1 month-T2, 3 months-T3, 6 months-T4).
COVARIATES: Covariates included age, sex, and operative time.
ANALYSIS: Data were analyzed using SPSSversion20. Frequencies (percentages) were compared using χ2 and Fisher's exact tests. Kaplan-Meier survival analysis and Cox-regression were used to assess recovery hazards, adjusting for covariates with level of statistical significance set at P < .05.
RESULTS: The sample composed of 65 subjects of unilateral TMJa undergoing surgery. The mean age was 20.13 ± 7.58 years and included 27 females (42%) and 38 males (58%). Iatrogenic FN injury occurred in 15 (23%) cases. The median time to detect FNF recovery by EEMG was 6 weeks (interquartile range [IQR] 3 to 12) versus HBS 15 weeks [IQR 11 to 19] versus SBS 18 weeks [IQR 13 to 20] which was statistically significant favoring EEMG (95% CI, P < .05). Complete recovery of FNF was noted in all 15 cases. The chance of early detection of recovery by EEMG was 32% greater than with HBS and SBS (hazard ratio: 1.32, 95% CI, 1.02 to 1.72, P < .05).
CONCLUSION AND RELEVANCE: EEMG detects FNF recovery earlier than grading scales, and is a valid electrodiagnostic test for postoperative monitoring.
PURPOSE: The purpose of this study was to determine whether evoked electromyography (EEMG) detects postoperative FN function (FNF) recovery earlier than House-Brackmann scale (HBS) and Sunnybrook scale (SBS) following TMJa surgery.
STUDY DESIGN, SETTING, SAMPLE: A prospective, single tertiary-care center cohort study was conducted at All India Institute of Medical Sciences, Rishikesh from October 2022 to April 2024. Patients with unilateral TMJa aged above 12 years were included. Exclusion criteria were previous surgery of parotid/temporomandibular joint, preexisting FN palsy, neuromuscular disorders, syndromic patients.
PREDICTOR VARIABLE: The primary predictor variable was FNF recovery monitoring tool (EEMG vs HBS vs SBS).
MAIN OUTCOME VARIABLES: The primary outcome variable was FNF recovery time. This was recorded postoperatively at defined time-points (1 week-T1, 1 month-T2, 3 months-T3, 6 months-T4).
COVARIATES: Covariates included age, sex, and operative time.
ANALYSIS: Data were analyzed using SPSSversion20. Frequencies (percentages) were compared using χ2 and Fisher's exact tests. Kaplan-Meier survival analysis and Cox-regression were used to assess recovery hazards, adjusting for covariates with level of statistical significance set at P < .05.
RESULTS: The sample composed of 65 subjects of unilateral TMJa undergoing surgery. The mean age was 20.13 ± 7.58 years and included 27 females (42%) and 38 males (58%). Iatrogenic FN injury occurred in 15 (23%) cases. The median time to detect FNF recovery by EEMG was 6 weeks (interquartile range [IQR] 3 to 12) versus HBS 15 weeks [IQR 11 to 19] versus SBS 18 weeks [IQR 13 to 20] which was statistically significant favoring EEMG (95% CI, P < .05). Complete recovery of FNF was noted in all 15 cases. The chance of early detection of recovery by EEMG was 32% greater than with HBS and SBS (hazard ratio: 1.32, 95% CI, 1.02 to 1.72, P < .05).
CONCLUSION AND RELEVANCE: EEMG detects FNF recovery earlier than grading scales, and is a valid electrodiagnostic test for postoperative monitoring.