Abstract
Intraoperative facial nerve monitoring (IOFNM) is a neurophysiological method whose main purpose is to inform the surgical team of the actual neural function—and, indirectly, of the position—of the facial nerve (N VII) so that the operative strategy can be consequently adjusted to avoid neural damage. The most commonly used—and therefore defined as “standard”—IOFNM techniques are direct electrical stimulation (DES) and free-running electromyography (EMG). DES allows for proper tracing of the course of N VII; the types of displacement reported have been correlated to tumor size and capsule adhesiveness in diverse studies. Functional changes in the activity of N VII—as detected by DES and EMG—also have a role in assessing postoperative functional prognosis. The technique of facial motor evoked potentials (FMEPs) is the most promising and latest frontier method in IOFNM as it surpasses most of the disadvantages of standard techniques.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Vivas EX, Carlson ML, Neff BA, Shepard NT, McCracken DJ, Sweeney AD, et al. Congress of neurological surgeons systematic review and evidence-based guidelines on intraoperative cranial nerve monitoring in vestibular schwannoma surgery. Neurosurgery. 2018;82(2):E44–E6.
Amano M, Kohno M, Nagata O, Taniguchi M, Sora S, Sato H. Intraoperative continuous monitoring of evoked facial nerve electromyograms in acoustic neuroma surgery. Acta Neurochir. 2011;153(5):1059–67; discussion 67.
Duarte-Costa S, Vaz R, Pinto D, Silveira F, Cerejo A. Predictive value of intraoperative neurophysiologic monitoring in assessing long-term facial function in grade IV vestibular schwannoma removal. Acta Neurochir. 2015;157(11):1991–7; discussion 8.
Liu SW, Jiang W, Zhang HQ, Li XP, Wan XY, Emmanuel B, et al. Intraoperative neuromonitoring for removal of large vestibular schwannoma: facial nerve outcome and predictive factors. Clin Neurol Neurosurg. 2015;133:83–9.
Mastronardi L, Cacciotti G, Roperto R. Intracanalicular vestibular schwannomas presenting with facial nerve paralysis. Acta Neurochir. 2018;160(4):689–93.
Acioly MA, Liebsch M, de Aguiar PH, Tatagiba M. Facial nerve monitoring during cerebellopontine angle and skull base tumor surgery: a systematic review from description to current success on function prediction. World Neurosurg. 2013;80(6):e271–300.
Nejo T, Kohno M, Nagata O, Sora S, Sato H. Dorsal displacement of the facial nerve in acoustic neuroma surgery: clinical features and surgical outcomes of 21 consecutive dorsal pattern cases. Neurosurg Rev. 2016;39(2):277–88; discussion 88.
Sameshima T, Morita A, Tanikawa R, Fukushima T, Friedman AH, Zenga F, et al. Evaluation of variation in the course of the facial nerve, nerve adhesion to tumors, and postoperative facial palsy in acoustic neuroma. J Neurol Surg B Skull Base. 2013;74(1):39–43.
Mastronardi L, Cacciotti G, Roperto R, Di Scipio E, Tonelli MP, Carpineta E. Position and course of facial nerve and postoperative facial nerve results in vestibular schwannoma microsurgery. World Neurosurg. 2016;94:174–80.
Bozorg Grayeli A, Kalamarides M, Fraysse B, Deguine O, Favre G, Martin C, et al. Comparison between intraoperative observations and electromyographic monitoring data for facial nerve outcome after vestibular schwannoma surgery. Acta Otolaryngol. 2005;125(10):1069–74.
Romstöck J, Strauss C, Fahlbusch R. Continuous electromyography monitoring of motor cranial nerves during cerebellopontine angle surgery. J Neurosurg. 2000;93(4):586–93.
Prell J, Rampp S, Romstöck J, Fahlbusch R, Strauss C. Train time as a quantitative electromyographic parameter for facial nerve function in patients undergoing surgery for vestibular schwannoma. J Neurosurg. 2007;106(5):826–32.
Matthies C, Raslan F, Schweitzer T, Hagen R, Roosen K, Reiners K. Facial motor evoked potentials in cerebellopontine angle surgery: technique, pitfalls and predictive value. Clin Neurol Neurosurg. 2011;113(10):872–9.
Acioly MA, de Aguiar PH, Tatagiba M. Continuous monitoring of evoked facial nerve electromyograms: a new device for an old concept. Acta Neurochir. 2011;153(11):2271–2; author reply 3–4.
Acioly MA, Gharabaghi A, Liebsch M, Carvalho CH, Aguiar PH, Tatagiba M. Quantitative parameters of facial motor evoked potential during vestibular schwannoma surgery predict postoperative facial nerve function. Acta Neurochir. 2011;153(6):1169–79.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Mastronardi, L., Campione, A., Zomorodi, A., Di Scipio, E., Adornetti, A., Fukushima, T. (2019). Intraoperative Identification and Location of Facial Nerve: Type of Facial Nerve Displacement—How to Use Monopolar Stimulator. In: Mastronardi, L., Fukushima, T., Campione, A. (eds) Advances in Vestibular Schwannoma Microneurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-030-03167-1_9
Download citation
DOI: https://doi.org/10.1007/978-3-030-03167-1_9
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-03166-4
Online ISBN: 978-3-030-03167-1
eBook Packages: MedicineMedicine (R0)