Intra-operative facial nerve monitoring. Its predictive value after skull base surgery

1997 ◽  
Vol 111 (8) ◽  
pp. 715-718 ◽  
Author(s):  
Giuseppe Magliulo ◽  
Francesco Zardo
Keyword(s):  
Facial Nerve ◽  
Skull Base ◽  
Predictive Value ◽  
Skull Base Surgery ◽  
Evoked Response ◽  
Nerve Function ◽  
Nerve Monitoring ◽  
Facial Nerve Monitoring ◽  
Stimulation Current ◽  
Facial Function

AbstractPurposeFacial nerve monitoring can be used to predict post-operative facial function after skull base surgery. In this study three methods of prediction of facial function were compared. These methods utilize various parameters of the evoked electromyographic monitoring.Material and methodsTwenty-three patients who underwent surgery for skull base diseases were retrospectively reviewed. Amplitude of ongoing electromyographic activity, stimulation current thresholds and amplitude of evoked response were analysed. The predictive value of the three methods was correlated with post-operative facial nerve function.ResultsThe method that used only the stimulation thresholds predicted the final post-operative facial function in 86.9 per cent of the patients. The second employed a mathematical ratio which combined the amplitude of evoked response and the stimulation current thresholds and confirmed the prediction of the facial function in 91.3 per cent of the patients. The last method does not consider the stimulation thresholds greater than 0.05 mA and failed to predict the final VIIth nerve function in patients in whom the stimulation was greater than 0.05 mA.ConclusionAnalysis of prognostic value demonstrates that the first two methods had the smaller degree of variation showing the better sensitivity.

Facial nerve monitoring in skull base surgery

1994 ◽  
Vol 108 (7) ◽  
pp. 557-559 ◽  
Author(s):  
Giuseppe Magliulo ◽  
Roberto Petti ◽  
Gianluca Maria Vingolo ◽  
Piera Cristofari ◽  
Roberta Ronzoni
Keyword(s):  
Facial Nerve ◽  
Skull Base ◽  
Normal Function ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Nerve Monitoring ◽  
Lateral Skull Base ◽  
Facial Nerve Monitoring ◽  
Skull Base Lesions ◽  
Nerve Dysfunction

AbstractThe purpose of this work was to compare pre- and post-operative facial nerve function between unmonitored and monitored cases of skull base lesions. The study involved 32 patients suffering from lateral skull base tumours (10 unmonitored and 22 monitored). Facial nerve function was monitored intraoperatively by an acoustic facial electromyographic system (NIM-2). Post-operative facial function was graded according to the House-Brackmann scale. In the group of monitored cases, facial nerve function was normal (Grade 1 or 2) in 79 per cent of the patients, while the unmonitored patients showed normal function in only 50 per cent of the cases.These results confirm previous observations that audible evoked electromyographic monitoring significantly reduces permanent facial nerve dysfunction.

Improved Preservation of Facial Nerve Function in the Infratemporal Approach to the Skull Base

1989 ◽  
Vol 101 (1) ◽  
pp. 74-78 ◽  
Author(s):  
John P. Leonetti ◽  
Derald E. Brackmann ◽  
Richard L. Prass
Keyword(s):  
Facial Nerve ◽  
Skull Base ◽  
Jugular Foramen ◽  
Early Postoperative Period ◽  
Modified Technique ◽  
Nerve Monitoring ◽  
Lateral Skull Base ◽  
Facial Nerve Monitoring ◽  
Infratemporal Approach ◽  
Facial Function

Although the infratemporal approach described by Fisch provides excellent exposure of the jugular foramen, intrapetrous carotid artery, and lateral skull base, the anterior displacement of the seventh cranial nerve often results In temporary facial paralysis. The use of a modified technique for facial nerve mobilization resulted In significant improvement of both early and final facial function. Since that earlier report, continuous intraoperative electrical facial nerve monitoring has been used during the infratemporal approach in 20 additional cases. Immediate postoperative facial function was normal in 93% of the monitored coses and In 70% of the cases in the unmonitored group. More Importantly, no patients in the monitored group developed grade V or VI weakness after surgery, whereas 48% of the unmonitored patients had grade V or VI weakness during the early postoperative period. This article will describe how intraoperative facial nerve monitoring is used during infratemporal surgery and will compare early facial function in 31 unmonitored patients with early facial function in 20 monitored procedures.

Electromyographic facial nerve monitoring during parotidectomy for benign lesions does not improve the outcome of postoperative facial nerve function: A prospective two-center trial

2009 ◽  
Vol 119 (12) ◽  
pp. 2299-2305 ◽  
Author(s):  
Maria Grosheva ◽  
Jens Peter Klussmann ◽  
Carolin Grimminger ◽  
Claus Wittekindt ◽  
Dirk Beutner ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Benign Lesions ◽  
Nerve Monitoring ◽  
Facial Nerve Monitoring

A Multifactorial Analysis of Facial Nerve Results in Surgery for Cerebellopontine Angle Tumors

1997 ◽  
Vol 76 (1) ◽  
pp. 37-40 ◽  
Author(s):  
Alan J. Nissen ◽  
Ashley Sikand ◽  
Joseph E. Welsh ◽  
Frank S. Curto ◽  
John Gardi
Keyword(s):  
Facial Nerve ◽  
Surgical Approach ◽  
Tumor Size ◽  
Tumor Resection ◽  
Outcome Data ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Nerve Monitoring ◽  
Use Of Data ◽  
Facial Nerve Monitoring

Preserving the function of the facial nerve remains a paramount objective in acoustic neuroma surgery. This study was undertaken to determine the influence of four independent variables on facial nerve outcome by means of a retrospective review of 111 surgical cases: 1) tumor size; 2) use of intraoperative facial nerve monitoring (IFNM); 3) completeness of tumor resection; and 4) surgical approach used. Partial tumor resection appeared to result in improved facial nerve outcome for patients with large tumors. Results indicated that tumor size did not correlate with facial nerve functional outcome, with no statistically significant differences observed among the three size categories. Facial nerve function was not found to depend on selection of either a translabyrinthine (n=47) or a suboccipital (n—55) surgical approach in that results were similar for both groups. Outcome data showed a trend in support of the use of IFNM, especially for large tumors, even though the differences between monitored and unmonitored groups were not statistically significant. This study describes the independent impact of the four factors generally thought to affect facial nerve outcome and, in addition, recommends the use of data stratification in reporting facial nerve function results.

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