{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:07:12Z","timestamp":1767139632088,"version":"build-2238731810"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2020,1,27]],"date-time":"2020-01-27T00:00:00Z","timestamp":1580083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,1,27]],"date-time":"2020-01-27T00:00:00Z","timestamp":1580083200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Arch Otorhinolaryngol"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      Early facial nerve palsy (eFNP) is the most frequent complication of the parotidectomy. Intraoperative neuromonitoring (IONM) in parotid surgery, which aims at reducing eFNP, has not evolved any further than the mere differentiation between the nerve and the surrounding tissue. Continuous IONM (cIONM), used in thyroid and posterior fossa surgery, has developed over the past years and has proved beneficial in reducing the rate of paresis in cases where a pattern of impending nerve injury is identified. In this study, we aim to demonstrate the safety of using the stimulating electrode (Saxophone\n                      <jats:sup>\u00ae<\/jats:sup>\n                      ) for cIONM in parotid surgery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      From 2016 to 2018, 40 patients who were referred for primary parotidectomy under cIONM according to our study protocol (registered at the German Clinical Trials Register, DRKS-ID: DRKS00011051,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.drks.de\">http:\/\/www.drks.de<\/jats:ext-link>\n                      ;\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/apps.who.int\/trialsearch\">http:\/\/apps.who.int\/trialsearch<\/jats:ext-link>\n                      ) were included in this study. All patients with a normal preoperative facial nerve function [House\u2013Brackman (HB)-Index 1] underwent surgery using continuous facial nerve stimulation with the Saxophone\n                      <jats:sup>\u00ae<\/jats:sup>\n                      electrode (system AVALANCHE XT, Dr. Langer Medical, Waldkirch, Germany). A control group which underwent parotidectomies with only intermittent IONM was recruited from our records.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Half of the patients in our study group suffered from eFNP. All except one regained normal facial nerve function within 6\u00a0months of surgery. There was no significant difference regarding eFNP when compared to the control group without cIONM (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.11). No statistically significant correlation between the stimulation threshold (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.74) or the duration of nerve stimulation and eFNP was found (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.51).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      We have demonstrated the safety of using the Saxophone\n                      <jats:sup>\u00ae<\/jats:sup>\n                      -electrode for cIONM of the facial nerve in parotid surgery. Future development of this method could enable the recognition of impending nerve injury and thus reduce eFNP.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00405-020-05803-4","type":"journal-article","created":{"date-parts":[[2020,1,27]],"date-time":"2020-01-27T02:02:37Z","timestamp":1580090557000},"page":"1449-1456","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Safety of the \u201cSaxophone\u00ae\u201d electrode in parotid surgery for continuous intraoperative neuromonitoring of the facial nerve: results of a pro- and retrospective cohort study"],"prefix":"10.1007","volume":"277","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0105-1489","authenticated-orcid":false,"given":"Petar","family":"Stankovic","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Wittlinger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Georgiew","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Dominas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrin","family":"Reimann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Hoch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1317-5224","authenticated-orcid":false,"given":"Thomas","family":"Wilhelm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"G\u00fcnzel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,1,27]]},"reference":[{"issue":"12","key":"5803_CR1","doi-asserted-by":"publisher","first-page":"2299","DOI":"10.1002\/lary.20637","volume":"119","author":"M Grosheva","year":"2009","unstructured":"Grosheva M, Klussmann JP, Grimminger C, Wittekindt C, Beutner D, Pantel M, Volk GF, Guntinas-Lichius O (2009) Electromyographic facial nerve monitoring during parotidectomy for benign lesions does not improve the outcome of postoperative facial nerve function: a prospective two-center trial. 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The study passed an evaluation of the Ethical Committee of Saxonian Chamber of Physicians. Data handling in accordance with national data protection laws and the anonymity of the patients was secured.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"An extended informed consent regarding the study and data analysis was obtained before inclusion to the study, for the retrospective chart analysis an informed consent was obtained according to a treatment contract from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}