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Assessment of intraoperative nerve monitoring parameters associated with facial nerve outcome in parotidectomy for benign disease

JAMA Otolaryngology—Head & Neck Surgery May 08, 2019

Haring CT, et al. - In this case series involving 222 subjects who had parotidectomy for benign disease, researchers identified intraoperative facial nerve monitoring parameters correlated with postoperative weakness and assessed cutoff values for these parameters under which normal nerve function is more likely. According to this retrospective case series, the rate of temporary facial nerve paresis of any nerve branch was 45%, and the rate of permanent paralysis was 1.3%. Data reported that the optimal cutoff value for the threshold was 0.25 mA and the optimal cutoff for the number of mechanical events was 8. Findings revealed that postdissection threshold and the number of mechanical events were linked to immediate postoperative facial nerve function. Precise prediction of facial nerve function may provide patients with anticipatory guidance and may provide intraoperative feedback to surgeons enabling adjustment in surgical techniques and perioperative management.
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