The Use Of Fasial Stımilator in Cochlear implant and Fasial Tumor Surgery

Abstract

Objective: Our aim in conducting this clinical study that project was to investigate the surgical safety of facial nerve monitoring along with its effects on the duration of the operation in otologic and neurotologic surgery. Methods: We have used intraoperative monitoring and stimulation of facial nerve function routinely in 161 cochlear surgery, and 10 neurotologic cases. Statistical study was performed only in otologic patients. The 171 patients who underwent surgery, of the remaning 30 otologic surgery cases were randomly selected that were monitered. The remaining 30 otologic surgery cases were not monitored and compared statistically for the duration of the operation and the emerging complications. Results: Of the study patients; no responses were detected in seven despite the stimulation. Response occurred only after increasing the amplitude of the stimulation current in two patients. In the remaining 162 patients, the responses were detected. Of the seven patients, in whom no responses were detected; electrode contact was lost in three, nerve fatigue was found in two, and muscle-relaxant use for anesthesia was detected in one patient; while, no causes were identified in one patient. Despite the presence of responses, a transient postoperative paresis was observed in one patient. In cochlear implant patients, the mean duration of surgery was 2.35 hours without monitoring; whereas, it was 1.45 hours in monitored patients. Conclusion: We are of the opinion that this technological method may contribute significantly to obtaining electrophysiologic data, as well as ensuring the safety of the operation and reducing the complication rates.