New Development in Intraoperative Video Monitoring of Facial Nerve: A Pilot Study

Objective: The present study proposes an evolution of an intraoperative video-based facial nerve monitoring system for otologic and otoneurosurgical procedures in comparison with classical electromyographic (EMG) monitoring method. Study Design: Single-subject design study. Setting: Tertiary referral center, university clinic. Patients: Fifteen patients undergoing a translabyrinthine approach for removal of 2 cm or less acoustic neuroma. Intervention: Intraoperative monitoring during acoustic neuroma removal. Main Outcome Measures: Measurement of mouth angle displacement and EMG peak amplitude at different stimulation intensities were measured and compared to evaluate the validity and reliability of the proposed new system. Results: The electrophysiologic method has been shown to be slightly more sensitive, although it shows limitations especially in terms of electrical artifacts during cauterization, totally masking the EMG monitoring. Conclusion: The present version of video system can be considered as valid and reliable as EMG; its main advantages are the absence of electrical artifacts, less invasivity, and much less cost.