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

Authors
Choung, YH; Park, K; Cho, MJ; Choung, PH; Shin, YR; Kahng, H
Citation
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 135(6):872-876, 2006
Journal Title
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
ISSN
0194-59981097-6817
Abstract
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" (<or=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.
MeSH terms
AdolescentAdultAgedChildChild, PreschoolCholesteatoma, Middle Ear/surgery*Electric Stimulation*Facial Nerve Injuries/etiologyFacial Nerve Injuries/pathologyFacial Nerve Injuries/prevention & control*HumansMastoid/surgeryMiddle AgedMonitoring, Intraoperative*Otitis Media/surgery*Prospective StudiesSurgical Wound Dehiscence/prevention & control*
DOI
10.1016/j.otohns.2006.04.008
PMID
17141076
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Otolaryngology
AJOU Authors
정, 연훈박, 기현
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