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Chirurgia 2013 December;26(6):395-400


language: English

Analysis of the thermal variation in the facial nerve induced by dissection of the mastoid with the use of low and high-power drills

Neto O. 1, 5, Oliveira T. 2, Dias T. 3, Rosa S. 4, Altoé M. 4, Moura F. 4, Freitas T. 1, 5, Schechtman N. 5, Kessler I. 5

1 Unit of Neurosurgery, Hospital de Base do Distrito Federal, Brasília, Brazil; 2 Unity of Ear Nose and Throat Hospital de Base do Distrito Federal, Brasília, Brazil; 3 Grupo VORTEX, ENM, University of Brasília, Brasília, Brazil; 4 Laboratório de Engenharia e Biomaterial – BioEngLab Engineering Electronic FGA, University of Brasília, Brasília, Brazil; 5 Unit of Neurosurgery, University of Brasília, Brasília, Brazil


Aim: Due to the large number of car accidents nowadays, and their close association with head trauma, considered a frequent cause of facial nerve injury and because of the anatomical transpetrosal route, a possible surgical decompression in some selected cases may be possible. Transoperative thermal injuries, due to decompressive procedure to the facial nerve, are common. These phenomena and their impact on the outcome of functional recovery of the facial nerve have not been assessed yet. This study aims to evaluate the thermal variation (in o C) of the facial nerve during a standard radical mastoidectomy performed both with a high and a low speed drill, using drilling with continuous irrigation versus drilling with irrigation on demand.
Methods: The sample group consisted of eight samples of Temporal Bones preserved in 10% Formaldehyde solution operated on continuous irrigation or irrigation on demand. Four were drilled with a high-speed drill and the other with a low speed device. Analysis of variance (ANOVA) was used for analysis of the data resulting from the study.
Results: The procedure performed with the high-speed drill with irrigation on demand had a higher temperature rise in the facial nerve in relation to other series. The low-speed drill with continuous irrigation provided the smallest temperature increase in the facial nerve (T = 20.1 ± 0.2 °C).
Conclusion: In the series with low and high-speed drilling with irrigation on demand the temperature increase caused by the drilling was sufficiently high enough to inflict potential thermal injury to the nerve.

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