Systematic facial nerve monitoring in middle ear and mastoid surgeries: "Surgical dehiscence" and "electrical dehiscence

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Choung, Yun-Hoon; Park, Keehyun; Cho, Min Jung; Choung, Pill-Hoon; Kahng, Hison; Shin, You Ree

Issue Date
SAGE Publications
Otolaryngology - Head and Neck Surgery, Vol.135 No.6, pp. 872-876
OBJECTIVES: To evaluate and systemize intraoperative facial nerve monitoring (IOFNM) in middle ear and mastoid surgeries. STUDY DESIGN AND SETTING: A prospective study. METHODS: IOFNM was performed in 100 patients undergoing middle ear and mastoid surgeries. We checked "surgical dehiscence" under microscopes, and also estimated the minimal threshold of electric current needed to change the electromyography of facial muscles using Nerve Integrity Monitor (NIM)-2 (Xomed, Minneapolis, MN, USA). RESULTS: Forty-three percent of cases showed "surgical dehiscence" and responded to electric stimulation of 0.7 mA or less. "Electrical dehiscence" (<= 0.7 mA) was presented in 73 (73.0%) cases, and 82.2% of these cases responded to 0.4 mA or less. The mean threshold of minimal electrical stimulation was 0.29 mA for tympanic segments and 0.41 mA for mastoid segments. CONCLUSIONS: We recommend an electrical stimulation of 0.7 mA for the first screening and 0.4 mA for the second exploration in order to define the facial nerve using intraoperative NIM-2 monitoring in middle ear and mastoid surgeries. (c) 2006 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.
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College of Dentistry/School of Dentistry (치과대학/치의학대학원)Dept. of Dentistry (치의학과)Journal Papers (저널논문_치의학과)
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