Electroneurography and Intraoperative Facial Monitoring in Contemporary Neurotology

1989 ◽  
Vol 101 (4) ◽  
pp. 496-503 ◽  
Author(s):  
Jack M. Kartush
Keyword(s):  
Facial Nerve ◽  
Intraoperative Monitoring ◽  
Bone Tumors ◽  
State Of The Art ◽  
Preoperative Assessment ◽  
Nerve Monitoring ◽  
Electrodiagnostic Testing ◽  
Malignant External Otitis ◽  
Facial Nerve Monitoring ◽  
Stimulation Of

Electrodiagnostic testing of the facial nerve has evolved beyond prognostic and topognostic testing to include preoperative assessment and intraoperative monitoring. The state of the art in facial nerve testing is herein reviewed. Electroneurography is described as a means of preoperative assessment to detect subclinical neural degeneration for temporal bone tumors, malignant external otitis, and recurring facial paralysis. Techniques of intraoperative facial nerve monitoring are presented with clinical correlation of the facial evoked responses. Finally, recent advances in electrodiagnostic testing. Including antidromic recording and transtemporal magnetic stimulation of the facial nerve, are discussed.

Intraoperative facial nerve monitoring: a description of a unique system

1994 ◽  
Vol 108 (7) ◽  
pp. 551-556 ◽  
Author(s):  
Richard J. Wiet ◽  
George P. Bauer ◽  
Don Stewart ◽  
John J. Zappia
Keyword(s):  
Facial Nerve ◽  
Auditory Feedback ◽  
Cerebellopontine Angle ◽  
Nerve Activity ◽  
Nerve Monitoring ◽  
Significant Stimulation ◽  
Unique System ◽  
Facial Nerve Monitoring ◽  
Nerve Identification ◽  
Stimulation Of

AbstractIntraoperative facial nerve monitoring has become an integral adjunct in facial nerve identification and preservation for patients undergoing cerebellopontine angle surgery. Since the first description of EMG monitoring of facial nerve activity intraoperatively, many systems have been developed. These systems often rely on unilateral monitoring of the facial nerve with auditory feedback to the surgeon, and it is difficult to distinguish between artifact and significant stimulation of the facial nerve.In this paper, we present the use of a bilateral, multialarm, facial nerve monitoring system that has multiple advantages over previous systems. Furthermore, we review our experience with this bilateral system, comparing a group of 50 monitored patients to a group of 50 unmonitored patients.

Hemifacial Spasm: Intraoperative Electromyographic Monitoring as a Guide for Microvascular Decompression

Neurosurgery ◽  
2001 ◽  
Vol 49 (6) ◽  
pp. 1365-1371 ◽  
Author(s):  
Jan Jakob A. Mooij ◽  
Mustafa K. Mustafa ◽  
Tom W. van Weerden
Keyword(s):  
Facial Nerve ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Intraoperative Monitoring ◽  
Cure Rate ◽  
Muscle Response ◽  
Nerve Monitoring ◽  
Abnormal Muscle Response ◽  
Facial Nerve Monitoring

ABSTRACT OBJECTIVE Microvascular decompression is the logical and well-accepted treatment of choice for hemifacial spasm (HFS). In experienced hands, good to excellent results can be obtained. However, sometimes the exact site of the vascular compression is unclear. The aim of this study was to analyze whether intraoperative monitoring by stimulated electromyography of the facial nerve may help to improve the results of vascular decompression for HFS. METHODS In a series of 74 patients operated for HFS, the impact of intraoperative facial nerve monitoring on the surgical procedure was analyzed by use of the clinical and operative patient records. The role of this type of monitoring, with assessment of the so-called abnormal muscle response, was broken down into four categories: a guiding, a confirming, an indirect confirming, or an inconclusive role. The relationship between abnormal muscle response monitoring results and final surgical outcome was analyzed. RESULTS The overall cure rate was 87.8%, including patients who had previously undergone unsuccessful operations. Complications were minor, and hearing impairment was found in 2.7% of patients. A guiding role of intraoperative monitoring was apparent in 33.8% of patients, and a confirming role was demonstrated in 52.7% of patients, which resulted in a positive contribution of approximately 87% for intraoperative facial monitoring in microvascular decompression for HFS. In patients defined as guiding cases, the cure rate was 92%. CONCLUSION This study demonstrates the applicability and usefulness of intraoperative facial nerve monitoring in microvascular decompression operations for HFS.

Intraoperative Facial Nerve Monitoring

1991 ◽  
Vol 24 (3) ◽  
pp. 709-725 ◽  
Author(s):  
Herbert Silverstein ◽  
Seth Rosenberg
Keyword(s):  
Facial Nerve ◽  
Nerve Monitoring ◽  
Facial Nerve Monitoring

scholarly journals Clinical Benefits of Facial Nerve Monitoring during Cerebellopontine Angle Surgery

2022 ◽  
Vol 12 (01) ◽  
pp. 9-27
Author(s):  
Ahmed A. Farag ◽  
Abd El-Kafy Sharaf El-Din Ibrahim ◽  
Islam M. Alaghory
Keyword(s):  
Facial Nerve ◽  
Cerebellopontine Angle ◽  
Nerve Monitoring ◽  
Facial Nerve Monitoring ◽  
Clinical Benefits

Additional Benefits of Facial Nerve Monitoring during Otologic Surgery

2020 ◽  
Vol 163 (3) ◽  
pp. 572-576
Author(s):  
Kelsey Casano ◽  
Gerard Giangrosso ◽  
Gauri Mankekar ◽  
Alexander Sevy ◽  
Rahul Mehta ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Structured Interviews ◽  
Nerve Monitoring ◽  
Tertiary Referral Center ◽  
Otologic Surgery ◽  
Increased Risk ◽  
Facial Nerve Monitoring ◽  
Adults And Children ◽  
Facial Nerve Stimulation

Objective This study assesses the role of facial nerve monitoring (FNM) for intraoperative decision making during otologic surgery and possible benefits beyond protecting facial nerve integrity. Study Design This prospective study examines intraoperative FNM data and structured interviews collected during 52 otologic procedures. Setting Tertiary referral center. Subjects and Methods Subjects include adults and children undergoing middle ear or mastoid surgery. Data include intraoperative neuromonitoring activity and structured interviews conducted with the operating surgeon immediately following surgery. Results Facial nerve stimulation was used to confirm the position of the nerve in 42 of 52 surgical procedures. In 26.9% of cases, the patient became “light” and moved under anesthesia, which was predicted by neuromonitoring 71.4% of the time. Through structured interviews, the operating surgeons reported the following. (1) The facial nerve took an unexpected anatomic course in 7.8% of patients and was difficult to identify in 39.2%. (2) The nerve was at increased risk of injury in 66.7% of cases due to chronic disease or previous surgery. (3) Among these high-risk cases, the monitor helped reduce the risk of nerve damage 100% of the time. (4) Neuromonitoring allowed the surgeon to operate faster 86.5% of the time, and (5) FNM allowed the resident to perform more of the operation 68.9% of the time. No patients experienced postoperative facial weakness. Conclusions Beyond potentially protecting facial nerve integrity, this study identified additional benefits of FNM, including warning of patient movement during anesthesia, confirming facial nerve anatomic location, reducing operative time, and enhancing resident surgical experience.

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