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Intraoperative facial nerve monitoring: a description of a unique system

Published online by Cambridge University Press:  29 June 2007

Richard J. Wiet*
Affiliation:
Departments of Otolaryngology-Head and Neck Surgery and Neurosurgery, Northwestern University Medical School, and Hinsdale Hospital, Chicago, Illinois, USA.
George P. Bauer
Affiliation:
Departments of Otolaryngology-Head and Neck Surgery and Neurosurgery, Northwestern University Medical School, and Hinsdale Hospital, Chicago, Illinois, USA.
Don Stewart
Affiliation:
Departments of Otolaryngology-Head and Neck Surgery and Neurosurgery, Northwestern University Medical School, and Hinsdale Hospital, Chicago, Illinois, USA.
John J. Zappia
Affiliation:
Departments of Otolaryngology-Head and Neck Surgery and Neurosurgery, Northwestern University Medical School, and Hinsdale Hospital, Chicago, Illinois, USA.
*
Richard J. Wiet, M.D., F.A.C.S.,The Chicago Otology Group Ltd, Suite 102, 950 York Road, Hinsdale, Illinosis 60521, USA. Fax: (708) 789-3137.

Abstract

Intraoperative 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.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1994

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References

Delgado, T. E., Bucheit, W. A., Rosenholtz, H. J. R., Chrissier, S. (1979) Intraoperative monitoring of facial muscle evoked responses obtained by intracranial stimulation of the facial nerve dissection. Neurosurgery 14(5): 418421.CrossRefGoogle Scholar
Dickens, J. R. E., Graham, S. S. (1991) A comparison of facial nerve monitoring systems in cerebellopontine angle surgery. American Journal of Otology 12(1): 16.Google Scholar
Harner, S. G., Dauke, J. R., Ebersold, M. S. (1986) Electrophysiologic monitoring of facial nerve during temporal bone surgery. Laryngoscope 96: 6569.CrossRefGoogle ScholarPubMed
Harner, S. G., Beatty, C. W., Daube, J. R. (1988a) Electrophysiologic monitoring of the facial nerve. In Instructional Courses. (Johnson, J. T., Blitzer, A. D., Ossoff, R. N., Thomas, J. R., eds.), C. V. Mosby Co., St Louis, pp 225230.Google Scholar
Harner, S. G., Dorbe, J. R., Beatty, C. W., Ebersold, M. J. (1988b) Intraoperative monitoring of the facial nerve. Laryngoscope 98: 209212.CrossRefGoogle ScholarPubMed
House, J. W., Brackmann, D. E. (1985) Facial nerve grading system. Otolaryngology-Head and Neck Surgery 93: 146147.CrossRefGoogle ScholarPubMed
Kartush, J. M., Bouchard, K. R. (1991) Intraoperative facial nerve monitoring, otology, neurology and skull base surgery. In Neuromonitoring in Otology and Head and Neck Surgery. (Kartush, J., Bouchard, R., eds.), Raven Press Ltd, New York, pp 99120.Google Scholar
Kwartler, J. A., Luxford, W. M., Atkins, J., Shelton, C. (1991) Facial nerve monitoring in acoustic tumour surgery. Otolaryngology-Head and Neck Surgery 104(6): 814817.CrossRefGoogle Scholar
Møller, A. R., Janetta, P. T. (1984) Preservation of facial function during removal of acoustic neuromas. Use of monopolar constant-voltage stimulation and EMG. Journal of Neurosurgery 61: 757760.CrossRefGoogle ScholarPubMed
Niparko, J. K., Kileny, P. R., Kemink, J. L., Lee, H. M., Graham, M. D. (1989) Neurophysiologic intraoperative monitoring: neurophysiologic facial nerve function. American Journal of Otology 10(1): 5561.Google ScholarPubMed
Rinney, S. E., Pross, R. (1986) Facial nerve dissection by use of acoustic (loudspeaker) facial EMG monitoring. Otolaryngology-Head and Neck Surgery 96(4): 458463.Google Scholar
Silverstein, H., Smouha, E. E., Jones, R. (1988) Routine intraoperative facial nerve monitoring during otologic surgery. American Journal of Otology 9(4): 269275.Google ScholarPubMed
Yingling, C. D., Gardi, J. N. (1992) Intraoperative monitoring of facial and cochlear nerves during acoustic neuroma surgery. Otolaryngologic Clinics of North America 75(2): 413448.CrossRefGoogle Scholar