Use of intraoperative monitoring of facial nerve during parotid gland tumour removal

Mukhtar, Insha Ul-Haq
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The neuromonitor has found widespread use in parotidectomies for the purposes of avoiding or minimising insult to the facial nerve. However, its exact utility has been questionable, with differing opinions regarding its most appropriate application, and with little consensus as to the threshold of an applied amplitude, generating a CMAP, can be said to accurately predict facial nerve dysfunction, as defined by the House-Brackmann score, one week following the parotidectomy. It is the purpose of this paper to definitely state as to the exact use of the neuromonitor; whether its utility is overstated or whether it may form the future of parotidectomies. We used a dichotomous approach, comparing all literature concerning the neuromonitor, both contemporary and historic, as well as expounding upon the electrophysiological basis of the device in order to reach a conclusion. The purpose of the neuromonitor encompasses the context of facial nerve preservation; it is our aim to also discussing both patient features and surgical features as a whole that may play a role in the development of facial nerve dysfunction. This provides us context to the overall utility of the neuromonitor and thus would enable us to fully assess the extent to which the neuromonitor may be utilised in preventing facial nerve dysfunction. It is thus we may further expound on the new, novel techniques that may be used in parotid gland surgery that would enable us to reduce facial nerve dysfunction as a main surgical complication in the management of parotid gland tumours
Parotid Gland Neuromonitor Facial Nerve