Intraoperative facial nerve monitoring. Technical aspects

Intraoperative facial nerve monitoring (FNM) is widely used as a method of assessing the anatomic and physiologic integrity of the facial nerve during procedures in which the nerve may be in jeopardy. The doctors of the Otologic Medical Group use intraoperative FNM during all neurotologic procedures. This technique can also be used for congenital ear surgery and complicated revision chronic ear surgery. On the basis of experience gained from more than 200 cases in which FNM has been used, definitive conclusions can be made in regard to technical aspects. This article will discuss indications for intraoperative FNM, electrode design, visual and auditory feedback, and the particulars about stimulators.