Utility of Combining FIESTA-C and MENSA for Facial Nerve Identification in Parotid Gland Surgery.

OBJECTIVE

Facial nerve palsy is a major complication of parotid surgery. Several reports have demonstrated that the intraparotid facial nerve can be directly visualized using MRI. This study aimed to evaluate the role of fast imaging employing steady-state acquisition cycled phases (FIESTA-C) and multi-echo steady-state acquisition (MENSA) in facial nerve identification and tumor localization.

METHODS

Thirty-six patients with parotid tumors were analyzed. We evaluated whether the facial nerve could be identified and assessed tumor localization. The diagnostic accuracies of FIESTA-C, MENSA, and their combinations were compared.

RESULTS

The main trunk of the facial nerve was identified in all patients, and its bifurcation into the temporofacial and cervicofacial divisions was visualized in 81% using FIESTA-C, 81% using MENSA, and 94% using their combinations. Tumor localization was correctly identified in 75%, 67%, and 83% using FIESTA-C, MENSA, and their combinations, respectively.

CONCLUSION

Combination of FIESTA-C and MENSA could improve the accuracy of facial nerve identification and tumor localization compared to either sequence alone.