Intraoperative Facial Nerve Monitoring in Cerebellopontine Angle Surgery

Predictive value of facial nerve electrophysiologic stimulation thresholds in cerebellopontine angle surgery

Samuel H. Selesnick, John F. Carew, Jonathan D. Victor, Carl W. Heise, and Jennifer Levine

Laryngoscope 106, 633-638 (1996)

Abstract

The predictive value of intraoperative stimulation thresholds for facial nerve function, using a constant current system was examined in 49 patients undergoing resection of cerebellopontine angle tumors. Immediately postoperatively, 75% of the 0.1 mA threshold group, 42% of the 0.2 mA group and 18% of the >= 0.3 mA group had good (Grade I or II) facial nerve function. One year postoperatively, 90% of the 0.1 mA group, 58% of the 0.2 mA group and 41% of the >= 0.3 mA group had Grade I or II function. A statistically significant breakpoint of 0.2 mA was found to predict good postoperative facial function. Delayed facial paralysis occurred in 22% of patients, but carried a favorable prognosis. Both current stimulation threshold and duration are necessary for a meaningful comparison of data between investigators.


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