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- Title
Intraoperative facial nerve monitoring: a comparison of stimulating electrodes.
- Authors
Kartush, Jack M.; Niparko, John K.; Bledsoe, Sanford C.; Graham, Malcolm D.; Kemink, John L.; Kartush, J M; Niparko, J K; Bledsoe, S C; Graham, M D; Kemink, J L
- Abstract
Preservation of the facial nerve during acoustic neuroma resection may be enhanced by the use of intraoperative electrical stimulation. Although stimulation of the extratemporal facial nerve is an effective and established procedure, anatomic differences of the intradural facial nerve and its microenvironment demand more exacting stimulus protocols. The absence of epineurium may make the intradural nerve more susceptible to mechanical or electrical trauma while intermittent pooling of cerebrospinal fluid (CSF) at the cerebellopontine angle may shunt current away from nerve. Four stimulus configurations were examined under varying conditions simulating CSF pooling. The results indicated that: 1. insulation of stimulating electrodes prevents CSF current shunting and allows utilization of a constant current source, and 2. monopolar and bipolar configurations demonstrate significantly different electrical characteristics which may be employed selectively based upon specific clinical goals.
- Subjects
PATIENT monitoring equipment; FACIAL nerve surgery; ELECTRODES; RESEARCH; INTRAOPERATIVE care; ANIMAL experimentation; RESEARCH methodology; EVALUATION research; MEDICAL cooperation; COMPARATIVE studies; ELECTRIC stimulation; MENIERE'S disease; ACOUSTIC neuroma; CEREBROSPINAL fluid; ELECTROMYOGRAPHY; FACIAL nerve; FACIAL muscles; GUINEA pigs
- Publication
Laryngoscope, 1985, Vol 95, Issue 12, p1536
- ISSN
0023-852X
- Publication type
journal article
- DOI
10.1288/00005537-198512000-00015