A new integrated system for neural stimulation and bipolar coagulation: preliminary study.
CONCLUSIONS
The proposed device can be useful for promoting safety during bipolar coagulation in many surgical procedures and/or regions.


OBJECTIVE
A new system that integrates a neural stimulator and a bipolar coagulator is proposed, to improve neural (facial nerve) safety during ENT surgical procedures. This study aimed to evaluate the system.


METHODS
A home-made constant current neural stimulator (0.1-2 mA, pulsed, duration 200 micros), was connected via an automatic switch to a commercial bipolar microcoagulator (Medicon Instrumente mod. 101, Germany). Under general anesthesia, the extra-petrous portion of the facial nerve was identified in three rabbits. The adequate functioning of the device was tested via: 1) neural stimulation and EMG monitoring in basal conditions; 2) bipolar coagulation of connective tissue surrounding the facial nerve; 3) final assessment of the functional integrity of the nerve, via an intraoperative EMG and a postoperative evaluation.


RESULTS
Data obtained from all three rabbits provided adequate results in terms of neural stimulation, correct coagulation of juxta-nervous tissue, and functional integrity of the facial nerve, both intraoperatively and postoperatively.
Bernardeschi
Daniele
D
Department of Otolaryngology, University of Rome La Sapienza, Policlinico Umberto I degrees, Rome, Italy. danyberna@inwind.it
Bertoli
Gian Antonio
GA
De Seta
Elio
E
Bava
Gianluca
G
Minni
Antonio
A
Filipo
Roberto
R
D000818:Animals; D004423:Ear / Q000601:surgery*; D004558:Electric Stimulation / Q000295:instrumentation*; D004564:Electrocoagulation / Q000295:instrumentation*; D004576:Electromyography / Q000295:instrumentation*; D005154:Facial Nerve / Q000503:physiopathology; D020220:Facial Nerve Injuries / Q000503:physiopathology / Q000517:prevention & control*; D005158:Facial Paralysis / Q000503:physiopathology / Q000517:prevention & control*; D008866:Microsurgery / Q000295:instrumentation; D016343:Monitoring, Intraoperative / Q000295:instrumentation*; D011817:Rabbits