title: Intraoperative identification of the facial nerve by needle electromyography stimulation with a burr.
abstract: The purpose of this research is to improve the safety of surgery for patients with a pathology of the middle and inner ear by preventing damage to the facial nerve by conducting intraoperative monitoring of the facial nerve by needle electromyography with continuous stimulation with a burr.
  
  
  METHODS
  The clinical part of the prospective study was carried out on 48 patients that were diagnosed with suppurative otitis media. After the surgery with intraoperative monitoring, the facial nerve with an intact bone wall was stimulated electrically in the potentially dangerous places of damage. Minimum (threshold) stimulation (mA) of the facial nerve with a threshold event of 100 μV was used to register EMG events. The anatomical part of the study was carried out on 30 unformalinized cadaver temporal bones from adult bodies. The statistical analysis of obtained data was carried out with parametric methods (Student's t-test), non-parametric correlation (Spearman's method) and regression analysis.
  
  
  RESULTS
  It was found that 1 mA of threshold amperage corresponded to 0.8 mm thickness of the bone wall of the facial canal. Values of transosseous threshold stimulation in potentially dangerous sections of the injury to the facial nerve were obtained.
  
  
  CONCLUSIONS
  These data lower the risk of paresis (paralysis) of the facial muscles during otologic surgery.
authors.forename: N N
authors.initials: NN
authors.lastname: Khamgushkeeva
authors.forename: I A
authors.initials: IA
authors.lastname: Anikin
authors.forename: A A
authors.initials: AA
authors.lastname: Korneyenkov
mesh_terms: D000328:Adult; D002102:Cadaver; D002508:Cephalometry; D004576:Electromyography / Q000295:instrumentation* / Q000379:methods; D005154:Facial Nerve / Q000033:anatomy & histology / Q000503:physiopathology*; D020220:Facial Nerve Injuries / Q000517:prevention & control; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008416:Mastoid / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D016343:Monitoring, Intraoperative / Q000295:instrumentation* / Q000379:methods; D010035:Otitis Media, Suppurative / Q000601:surgery*; D011446:Prospective Studies; D013525:Surgical Instruments; D013701:Temporal Bone / Q000033:anatomy & histology; D014057:Tomography, X-Ray Computed