Abstract
Intraoperative facial nerve neuromonitoring (FN-IOM) has been established as one of the methods by which neurosurgery can improve surgical results while reducing morbidity. Despite routine use of FN-IOM, FN injury is still a complication of major concern due to severe impact on patient’s quality of life. Currently, standard monitoring techniques comprise direct electrical stimulation (DES), free-running electromyography (EMG) and facial motor evoked potential (FMEP). Recently, intraoperative recording of Blink Reflex (BR) can also be used. We report our experience of FN-IOM in 56 patients who underwent surgery for cerebellopontine angle tumors, trigeminal neuralgias or hemifacial spasms. FN was monitored with DES, EMG and, in 19 patients, also with BR. Facial nerve outcomes were evaluated one week and six months after surgery using the House–Brackmann scale (HB). Nine patients (16,1%) had HB grade III–VI function at 6 months after surgery. Individually, DES and EMG can predict FN function at 6 months, but used together, in a multimodal monitoring approach, the sensibility is higher. BR can predict FN function only one week after surgery. With our experience we want to emphasize the role of multimodal FN monitoring and its impact on facial nerve function preservation.
Published Version
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