[Intraoperative monitoring of the facial nerve: anesthesia and neurophysiology considerations].
Intraoperative monitoring of the motor component of the 7th cranial pair or any other nerve should be routine during any surgical procedure involving risk of neural damage, whether or not the skull is opened. This paper discusses the main indications for monitoring facial and acoustic nerves during ear and neurosurgery involving the pontocerebellar angle (for acoustic neuroma or in surgery on the 8th cranial pair). Intraoperative electromyographic monitoring of the facial nerve should be used routinely in acoustic neuroma surgery to reduce the degree of postoperative neurological impairment and avoid possible malpractice suits. Although such monitoring requires that the muscle remain unblocked, intraoperative neuromuscular relaxants can be used if doses are administered along with appropriate monitoring of the level of peripheral neuromuscular block.
Ingelmo
I
I
Servicio de Neuroanestesiología, Reanimación y UCI-Neuro Hospital Universitario Ramón y Cajal Ctra. Colmenar, km. 9,100 28034 Madrid.
Trapero
J G
JG
Puig
A
A
De Blas
G
G
Regidor
I
I
León
J M
JM
D000758:Anesthesia / Q000379:methods; D004576:Electromyography / Q000295:instrumentation; D004867:Equipment Design; D005154:Facial Nerve / Q000033:anatomy & histology / Q000502:physiology*; D006801:Humans; D016343:Monitoring, Intraoperative