Objective:

To evaluate the clinical utility of advanced magnetic resonance neurography and 3D modeling for preoperative facial nerve assessment in parotid tumor cases, focusing on visualization accuracy and surgical planning.

Key Findings:

• Advanced imaging sequences enable reliable visualization of the facial nerve trunk and its primary bifurcation, enhancing surgical planning.
• Mapping distal nerve branches remains technically challenging, impacting surgical outcomes.
• Quantitative parameters and radiomic profiles may aid in peritumoral risk stratification but require validation as standalone methods for detecting perineural invasion.
• Fusing imaging findings with patient-specific 3D models may facilitate targeted surgical approaches, improving surgical precision.

Interpretation:

Advanced MRN serves as an adjunctive tool for optimizing preoperative planning, complementing existing surgical practices but cannot replace intraoperative judgment or established safety protocols.

Limitations:

• The review does not include a formal quality assessment or risk-of-bias evaluation of the included studies, which may affect the reliability of the findings.
• Strict inclusion and exclusion criteria may limit the generalizability of findings to broader clinical settings.

Conclusion:

Integrating advanced MRN may provide additional anatomical insights to supplement traditional landmarks, potentially facilitating a more informed surgical approach and improving patient outcomes.