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Intraoperative facial nerve monitoring: A comparison of stimulating electrodes
Author(s) -
Kartush Jack M.,
Niparko John K.,
Bledsoe Sanford C.,
Graham Malcolm D.,
Kemink John L.
Publication year - 1985
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-198512000-00015
Subject(s) - facial nerve , cerebellopontine angle , stimulus (psychology) , epineurium , shunting , medicine , cerebrospinal fluid , stimulation , neuroma , biomedical engineering , anesthesia , surgery , radiology , magnetic resonance imaging , pathology , psychology , sciatic nerve , psychotherapist
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.