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Facial nerve monitoring in skull base surgery

Published online by Cambridge University Press:  29 June 2007

Giuseppe Magliulo*
Affiliation:
Fourth ENT Clinic, University ‘La Sapienza ’ Rome, Italy.
Roberto Petti
Affiliation:
Fourth ENT Clinic, University ‘La Sapienza ’ Rome, Italy.
Gianluca Maria Vingolo
Affiliation:
Fourth ENT Clinic, University ‘La Sapienza ’ Rome, Italy.
Piera Cristofari
Affiliation:
Fourth ENT Clinic, University ‘La Sapienza ’ Rome, Italy.
Roberta Ronzoni
Affiliation:
Fourth ENT Clinic, University ‘La Sapienza ’ Rome, Italy.
*
Giuseppe Magliulo, M.D.,Via Ormisda 10, 00165 Roma, Italy.

Abstract

The 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.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1994

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References

Fisch, U. (1982) Infratemporal fossa approach for glomus tumours of the temporal bone. Annals ofOtology, Rhinology and Laryngology 91: 474479.CrossRefGoogle ScholarPubMed
Harner, S. G., Daube, J. R., Beatty, C. W. (1988) Intraoperative monitoring of facial nerve. Laryngoscope 98: 209212.CrossRefGoogle ScholarPubMed
House, W., Hitselberger, W. (1976) The transcochlear approach to the skull base. Archives of Otolaryngology 102: 334342.CrossRefGoogle ScholarPubMed
House, J. W., Brackmann, D. E. (1985) Facial nerve grading system. Otolaryngology-Head and Neck Surgery 93: 146147.CrossRefGoogle ScholarPubMed
Kartush, J. M. (1989) Electroneurography and intraoperative facial monitoring in contemporary neurology. Otolaryngology-Head and Neck Surgery 101: 496503.CrossRefGoogle Scholar
Kartush, J. M., Larouere, M. J., Graham, M. D., Bouchard, K. R., Audet, B. V. (1991) Intraoperative cranial nerve monitoring during posterior skull base surgery. Skull Base Surgery 1: 8592.CrossRefGoogle ScholarPubMed
Leonetti, J. P., Brackmann, D. E., Prass, R. L. (1989) Improved preservation of facial nerve function in the infratemporal approach of the skull base. Otolaryngology-Head and Neck Surgery 101: 7478.CrossRefGoogle ScholarPubMed
Luetje, A. M. (1989) Intraoperative monitoring. American Journal of Otology 10: (Editorial).Google ScholarPubMed
Makek, M., Franklin, D. J., Zhao, J. C., Fisch, U. (1990) Neural infiltration of glomus temporale tumours. American Journal of Otology 11: 15.Google Scholar
Newell, D. J., Leonetti, J. P., Wharf, P. R. N. (1992) Intraoperative facial nerve monitoring during lateral skull base surgery. Skull Base Surgery 2: 62.Google Scholar
Prass, R. L., Luders, H. (1986) Facial electromyographic monitoring: evoked electromyographic activity during acoustic neuroma resection. Neurosurgery 19: 392400.Google ScholarPubMed
Silverstein, H., Smouha, E., Jones, R., Sarasota, F. L. (1989) Routine identification of the facial nerve using electrical stimulation during otological and neurotological surgery. Laryngoscope 98: 727730.Google Scholar
Stechison, M. T. (1992) Cranial nerve monitoring in skull base surgery. Skull Base Surgery 2: 51.Google Scholar