Three-dimensional anatomical model of the facial nerve in 100 parotid tumours: improved planning and personalised surgery.

Abstract

Surgeons currently operate blind to the facial nerve and can encounter unexpected events during surgery. The ability to track the facial nerve through the parotid gland prior to surgery would aid surgical planning and ideally improve outcomes. An audit was undertaken of 100 patients with parotid tumours. Each had a 3 Tesla magnetic resonance imaging (MRI) scan, with the DICOM data segmented into three-dimensional (3D) models of the facial nerve, tumour, and surrounding anatomy. The objective was to assess the value of 3D models in the management of parotid tumours. Of the 86/100 patients who proceeded to surgery, the 3D models were accurate in 98% of cases. The scale of surgical complexity predicted by the models correlated with operative duration and complications (p = 0.01). There was concordance (p = 0.01) between surgeons on the value of 3D models in different patients. 3D images from 3T MRI scans provide accurate visualisation of the facial nerve in parotid surgery. This novel technique facilitates improved preoperative planning, the prospect of improved outcomes, and a personalised approach to parotid surgery.