title: Our experience with facial nerve monitoring in vestibular schwannoma surgery under partial neuromuscular blockade.
abstract: OBJECTIVE
  Facial nerve monitoring is fundamental in the preservation of the facial nerve in vestibular schwannoma surgery. Our objective was to analyse the usefulness of facial nerve monitoring under partial neuromuscular blockade.
  
  
  METHODS
  This was a retrospective analysis of 69 patients operated in a tertiary hospital.
  
  
  RESULTS
  We monitored 100% of the cases. In 75% of the cases, we could measure an electromyographic response after tumour resection. In 17 cases, there was an absence of electromyographic response. Fifteen of them had an anatomic lesion with loss of continuity of the facial nerve and, in 2 cases, there was a lesion with preservation of the nerve. Preoperative facial palsy (29% 7%; P=.0349), large tumour size (88 vs. 38%; P=.0276), and a non-functional audition (88 vs. 51%; P=.0276) were significantly related with an absence of electromyographic response.
  
  
  CONCLUSIONS
  Facial nerve monitoring under neuromuscular blockade is possible and safe in patients without previous facial palsy. If the patient had an electromyographic response after tumour excision, they developed better facial function in the postoperative period and after a year of follow up.
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España. Electronic address: jorgevegaceliz@gmail.com.
authors.forename: Jorge
authors.initials: J
authors.lastname: Vega-Céliz
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
authors.forename: Emili
authors.initials: E
authors.lastname: Amilibia-Cabeza
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
authors.forename: José
authors.initials: J
authors.lastname: Prades-Martí
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
authors.forename: Nuria
authors.initials: N
authors.lastname: Miró-Castillo
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
authors.forename: Marta
authors.initials: M
authors.lastname: Pérez-Grau
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
authors.forename: Teresa
authors.initials: T
authors.lastname: Pintanel Rius
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
authors.forename: Francesc
authors.initials: F
authors.lastname: Roca-Ribas Serdà
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D002648:Child; D003131:Combined Modality Therapy; D004576:Electromyography; D005154:Facial Nerve / Q000503:physiopathology*; D020220:Facial Nerve Injuries / Q000209:etiology / Q000517:prevention & control*; D005158:Facial Paralysis / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009464:Neuroma, Acoustic / Q000150:complications / Q000532:radiotherapy / Q000601:surgery*; D019148:Neuromuscular Blockade; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Bloqueo neuromuscular; Facial nerve; Intraoperative monitoring; Monitorización intraoperatoria; Nervio facial; Neuromuscular block; Schwannoma vestibular; Vestibular schwannoma