Intraoperative videomonitoring of the facial nerve.

OBJECTIVE

To propose the application of an intraoperative videomonitoring system in otologic and otoneurologic surgery. The authors also compare results obtained by using this system with findings deriving from electromyography and pneumosensorial monitoring methods.

STUDY

DESIGN

The single-subject design study, involving six patients with middle ear or otoneurosurgery, compares reliability of different monitoring procedures, especially in terms of advantages and drawbacks.

SETTING

Video system versus electrophysiologic and pneumosensorial systems.

PATIENTS: Two patients affected with chronic otitis media, two from Meniere's disease, and two from Acoustic Neuroma.

INTERVENTIONS: Intraoperative diagnostic and prognostic.

RESULTS

Electrophysiologic method shows more sensibility, but is affected by a moderate grade of false positive because of electric artifacts; videomonitoring system showed less sensibility, but appears reliable; pneumosensorial system gives in-between results.

CONCLUSIONS

In intraoperative monitoring techniques, reliability and feasibility are the most important factors and are achieved, in this study, by the videomonitorig system. Video recording of images have permitted further off-line analysis.