Evaluation of Facial Nerve Imaging using CRANI for Parotid Gland Mass: Preliminary Experience.

Motivation: Restricted visualization of the extra foraminal facial nerve inhibits pre-operative decision-making in parotid gland mass regarding nerve preservation. Goal(s): Using 3D CRANI (CRanial Nerve Imaging) MR sequence, extra foraminal facial nerve was studied, focusing its anatomical relationship to parotid gland mass. Approach: In 10 patients, post-contrast CRANI sequence was obtained in 3T scanner with 32-ch coil and Compressed SENSE imaging to study its extraforaminal course. Multi-planar and maximum-intensity projections was generated to enhance visibility. Results: Extraforaminal segments of the facial nerve was well visualized up to its bifurcation. However, the visualization of branches distal to bifurcation in relation to the lesion was poor. Impact: Extraforaminal facial nerve and its relationship to parotid mass allows surgeons to make better preoperative assessments. CRANI sequence effectively enables proximal nerve tracking while lacks in distal branch visualization in presence of mass; an avenue for future refinements.