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BMC Surg 2021 Jul 3;21(1):306. Epub 2021 Jul 3.

Department of Otolaryngology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shaanxi Province, China.

Background: First branchial cleft anomaly (FBCA) is a rare congenital defect that arises due to incomplete closure of the ventral portion of the first and second branchial arches. There are variable complex clinical manifestations for patients with FBCA, which are prone to misdiagnosis and inadequate treatment. FBCAs usually involve the facial nerve with a consequent increased risk of facial nerve damage. Read More

Sci Rep 2019 07 19;9(1):10486. Epub 2019 Jul 19.

Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

The degree of neuromuscular blockade reversal may affect bispectral index (BIS) value. One possible reason is that the reverse of neuromuscular blockade affects electromyographic (EMG) signals of fascial muscle. Another reason is, the afferentation theory, the reverse of neuromuscular blockade relieves block signals generated in muscle stretch receptors from accessing the brain through afferent nerve pathways and induces arousal. Read More

Anesth Analg 2018 07;127(1):71-80

Department of Anesthesiology, University of Utah, Salt Lake City, Utah.

A panel of clinician scientists with expertise in neuromuscular blockade (NMB) monitoring was convened with a charge to prepare a consensus statement on indications for and proper use of such monitors. The aims of this article are to: (a) provide the rationale and scientific basis for the use of quantitative NMB monitoring; (b) offer a set of recommendations for quantitative NMB monitoring standards; (c) specify educational goals; and (d) propose training recommendations to ensure proper neuromuscular monitoring and management. The panel believes that whenever a neuromuscular blocker is administered, neuromuscular function must be monitored by observing the evoked muscular response to peripheral nerve stimulation. Read More

Eur Arch Otorhinolaryngol 2017 Sep 20;274(9):3465-3470. Epub 2017 Jun 20.

Department of Otolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing, 100045, People's Republic of China.

The objective of this study is to make a clinical analysis for first branchial cleft anomalies (FBCAs), especially introduce the relationship between the Type I/II FBCA with the facial nerve and to demonstrate the importance of using intraoperative microscope and facial nerve monitoring. This is a retrospective review of patients with FBCAs treated in Beijing Children's Hospital, from Jan 2013 to Dec 2015. Clinical data of patients, including sex, age, chief complains, history of surgery, incision and drainage, the relationship with the facial nerve, pre and post-operative facial paralysis, recurrent rate and complications were recorded. Read More

World Neurosurg 2017 Jul 19;103:310-314. Epub 2017 Apr 19.

Department of Neurosurgery, Nagoya University Graduate School of Medicine, Aichi, Japan.

Background: Endoscopic surgery has rapidly become widespread in neurosurgery in recent years. Endoscopy can offer close and panoramic surgical views with fine illumination, even in the deep intracranial area. However, it also has the following serious drawback: an intracranial blind area between the field lens of the endoscope and the site of the dural opening. Read More

J Clin Anesth 2017 Feb 30;37:61-62. Epub 2016 Dec 30.

Dept. of Neuroanaesthesia, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka 560029, India. Electronic address:

Bispectral index is an accepted depth of anaesthesia monitor for guiding intraoperative hypnotic agent administration. Frontalis EMG displayed on BIS monitor may increase due to twitching of frontalis muscle. EMG increases are also known to cause artefactual increases in BIS values. Read More

J Neurol Surg B Skull Base 2012 Feb;73(1):21-7

Area of Otolaryngology;

In this study we evaluate the postoperative facial nerve function after vestibular schwannoma (VS) surgery and analyze the factors that cause it. We included 97 consecutive patients undergoing surgical excision of sporadic unilateral VS. Patient and tumor characteristics, surgical approaches, facial nerve function, extent of tumor removal, perioperative complications are all analyzed through standardized systems. Read More

Rev Esp Anestesiol Reanim 2012 Oct 30;59(8):459-60. Epub 2012 Jun 30.

Anesth Analg 2009 Aug;109(2):551-8

Department of Anesthesiology, Loyola University Medical Center, Maywood, Illinois 60153, USA.

Background: Facial nerve (FN) monitoring has been accepted as a standard of care in craniofacial, middle ear, and skull-based surgeries as a means of reducing iatrogenic injury, localizing the FN, and predicting postoperative neurologic function. Past studies have also shown that FN electromyographic monitoring (FNEMG) may have some clinical utility as a monitor of anesthetic depth and predicting patient movement. In this study, we evaluated Bispectral Index (BIS) and FNEMG using two different anesthetic techniques to determine whether these monitors can be used to predict movement in patients undergoing skull-based surgical procedures. Read More

Otolaryngol Head Neck Surg 2005 Sep;133(3):313-8

Department of Otolaryngology--Head and Neck Surgery, Wilford Hall Medical Center, Lackland AFB, TX 78236-5300, USA.

Objective: To determine current patterns of use of facial nerve monitoring during parotid gland surgery by otolaryngologists in the United States.

Study Design And Setting: A questionnaire encompassing surgeon training background, practice setting, patterns of facial nerve monitor usage during parotid gland surgery, and history of permanent facial nerve injury or legal action resulting from parotid surgery was mailed to 3139 otolaryngologists in the United States. Associations between facial nerve monitor usage and dependent variables were examined by using the chi(2) test. Read More

Eur J Anaesthesiol 2001 Jul;18(7):423-39

Department of Anaesthesiology, Hospital Clínico, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain.

The aim of specific monitoring in neuroanaesthesia is to detect, as quickly as possible, intraoperative ischaemic insults so that the brain and the spinal cord may be protected from harmful and frequently inevitable events due to the type of surgery, patient positioning, haemodynamic changes or any intercurrent event. New monitors are being introduced into the operating theatre, but only a few are considered to be an absolute standard of care in neurosurgery, e.g. Read More

Am J Otol 1999 Nov;20(6):793-9

Objectives: To examine the hypothesis that for intraoperative facial nerve monitoring, an EMG monitor is more sensitive than a mechanical-pressure monitor. To compare the threshold sensitivity of the two facial nerve monitoring methods-mechanical-pressure versus EMG--by using them simultaneously during surgery. To assess and compare their true- and false-positive responses in otologic and neurotologic procedures. Read More

Otolaryngol Head Neck Surg 1998 Nov;119(5):468-70

Department of Surgery, Christiana Care Health System, Wilmington, Delaware, USA.

Recent reports have suggested that the incidence of permanent facial nerve paralysis or paresis after surgery for benign parotid tumors is between 3% and 5%. The intraoperative use of nerve-integrity monitors has been advocated to reduce the incidence of facial nerve paralysis. The purpose of this study was to compare postoperative facial nerve function after monitored and unmonitored parotid surgical procedures. Read More

Laryngoscope 1994 May;104(5 Pt 1):539-44

Ear Research Foundation, Sarasota, FL 34239.

Methods of monitoring the facial nerve during posterior fossa surgery continue to evolve. In an effort to predict acute and final facial nerve function following acoustic neuroma resection, the lowest current applied to the facial nerve at the brainstem necessary to elicit facial muscle response was measured using strain gauge and electromyographic facial nerve monitors. A retrospective analysis of 121 patients who had undergone acoustic neuroma surgery was performed. Read More