Label-Free Facial Nerve Identification During Parotidectomy Using Nerve Autofluorescence: An Initial Clinical Series
Abstract
Facial nerve (FN) dysfunction remains a clinically important complication of parotidectomy, even when recovery is ultimately complete. Traditional nerve identification relies on anatomic dissection, selective stimulation, and, in many cases, intraoperative monitoring (IONM). These approaches may be limited when anatomy is distorted. This study evaluated the feasibility, safety, and utility of autofluorescence-guided FN identification during parotidectomy. A retrospective case series was conducted in 18 patients who underwent superficial or total parotidectomy for parotid gland tumors. All procedures were performed by the same surgical team using standard operative technique and selective electrical nerve stimulation. Near-ultraviolet (NUV) autofluorescence imaging was obtained immediately after FN exposure and before further dissection. Raw grayscale and real-time colored overlay images were acquired. Quantitative image analysis was performed using manually selected regions of interest to measure nerve and background intensities, nerve-to-background ratio, longitudinal signal homogeneity, and apparent branch width. Given the case series design, findings were summarized using descriptive statistics. The cohort included 18 patients, 15 women and 3 men, who underwent superficial or total parotidectomy for parotid neoplasms. Final pathology showed pleomorphic adenoma in 15 cases and carcinoma in 3 cases, with deep lobe involvement in 1 case. Autofluorescence imaging generated…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 18 participants or records.
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