ArticleOtolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery2025
Correlation of Facial Nerve Function and Electrical Stimulation During Vestibular Schwannoma Surgery.
Article in Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThe aim of the present study is to identify electrophysiological parameters in facial nerve monitoring that provide the best predictive values in vestibular schwannoma surgery. STUDY
designRetrospective study.
settingTertiary care hospital.
methodsIn total, 76 patients undergoing translabyrinthine vestibular schwannoma resection were included. Facial nerve monitoring was conducted with free-running electromyography and direct electrical stimulation. Direct electrical stimulation protocol was predicated on a constant-current delivery at the root exit zone before and after tumor excision; specifically, recordings were made with increasing current settings: 0.05, 0.1, and 0.3 mA. The maximum amplitude measured from either of the two muscle groups was used for further correlations. Facial nerve function was graded according to the House-Brackmann (HB) scale before and after tumor excision.
resultsImmediate postoperative facial nerve outcomes were HB I (21%), HB II (40%), HB III (18%), HB IV (9%), and HB V (12%). Long-term facial nerve outcomes were distributed as follows: 66% HB I, 21% HB II, 12% HB III, and 1% HB IV. Results show that patients with a higher amplitude ≥ 1024 μV at orbicularis oris and/or frontalis had a >90% estimated probability of an HB I-II score in the long term. In contrast, patients with a low amplitude of, for example, 128 μV at orbicularis oris had an estimated 53% probability of an HB score of III or IV in the long term.
conclusionFacial nerve monitoring is an indispensable objective measure during vestibular schwannoma surgery. Higher amplitudes lead to more favorable results for patients. Amplitudes 500 and 1000 μV seem to be useful cutoff points to help guide patient expectations with respectively >84% and >90% estimated probability of an HB I-II score in the long term. LEVEL OF EVIDENCE: 3:
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