Intraoperative monitoring of the facial nerve.

Anatomic preservation of the facial nerve, with maximal facial function, is one of the goals of acoustic neuroma surgery. Application of electrophysiologic monitoring techniques is useful in achieving this goal. Preoperative electromyography and nerve conduction studies provide important prognostic information for preservation of the nerve and postoperative function. Intraoperative electromyography alerts the surgeon to facial nerve proximity and potential injury. Direct nerve stimulation is utilized to confirm the location and integrity of the nerve. Matched-pair analysis of two groups of patients demonstrated an increased ability to preserve the facial nerve with less postoperative facial deformity.