Abstract
Intraoperative neurophysiological monitoring of Facial nerve (FN) has become an integral part of CPA surgery, mainly to preserve nerves functional integrity. Deletis et al. (2009) described a technique to elicit the blink reflex (BR) during anaesthesia. Our aim was to investigate technical aspects, success rate of BR during IOM, its reliability and usefulness in predicting FN outcome. 19 pts affected by APC tumours (neurinoma, meningioma and brainstem astrocytoma) and hemifacial spasm were studied. Free run EMG, FN cMAP and BR were recorded during surgery. BR was recordable in 90%. There was a good correlation between BR stability and positive outcome. The patient who showed BR decrement or disappearance had a severe FN deficit at postIOM evaluation. BR is a method of simple execution that does not interfere with neurosurgeon activity. It can be added to other classical techniques to improve IOM reliability.
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