[Intraoperative facial nerve monitoring in parotid gland surgery].
OBJECTIVE
To re-evaluate the value and the methods of intraoperative facial nerve monitoring in parotid gland surgery.


METHODS
Sixty-five cases received intraoperative facial nerve monitoring in parotidectomy (test group) since 2000 - 2008. The facial nerve was identified through central trunk method (n = 18), branch method (n = 35) and mixed method (n = 12). Most patients accepted general anesthesia by incubation. The operating duration and minimum electronic stimulation threshold values of EMG in evoked facial muscle were recorded. Facial nerve was identified though branch method (n = 44) and no intraoperative facial nerve monitoring was performed in parotidectomy (control group).


RESULTS
There were four cases (6.1%) of mild temporary paralysis and no permanent post-operative paralysis of facial nerve in the test group. The average operating duration was 1.8 hour. The minimum reactive electronic stimulation threshold of EMG in evoked facial muscle was 0.08 mA. The range of suitable electronic stimulation threshold of EMG was from 0.2 mA to 1.0 mA. While there were nine cases (20.5%) of mild temporary paralysis and two cases (4.5%) of permanent post-operative paralysis of facial nerve in the control group and the average operating duration was 3.0 hours.


CONCLUSIONS
Intraoperative facial nerve monitoring (IFNM) in parotidectomy can assist a surgeon to confirm and identify the facial nerve and exercise precautions so as to shorten operating duration and prevent potential surgical complications.
Yuan
Wei
W
Center of Otolaryngology & Head Neck Surgery of PLA, Navy General Hospital, Beijing 100048, China.
Sun
Jian-jun
JJ
Li
Jin-rang
JR
Guo
Hong-guang
HG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004576:Electromyography; D005154:Facial Nerve / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010306:Parotid Gland / Q000294:innervation / Q000601:surgery; D010307:Parotid Neoplasms / Q000503:physiopathology* / Q000601:surgery*; D055815:Young Adult