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Updated: May 29, 2026

Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
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Continuous facial nerve stimulating burr for otologic surgeries.

Daniele Bernardeschi1, Nawel Meskine, Naif Al Otaibi

  • 1AP-HP, Hosp Beaujon, ENT Department, Clichy, France. daniele.bernardeschi@bjn.aphp.fr

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|September 6, 2011
PubMed
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The StimBurGard continuous facial nerve (FN) stimulating burr is safe and effective for identifying the FN during otologic surgery. Using 1 mA stimulation reliably preserves the integrity of the Fallopian canal (FC).

Area of Science:

  • Neurosurgery and Otology
  • Facial Nerve Monitoring
  • Surgical Safety Technologies

Background:

  • Protecting the facial nerve (FN) during otologic and neurotologic procedures is critical.
  • Drilling near the Fallopian canal (FC) carries a risk of FN injury.
  • The StimBurGard is a novel continuous FN stimulating burr designed to enhance intraoperative safety.

Purpose of the Study:

  • To evaluate the safety and reliability of the StimBurGard for FN identification during drilling near the mastoid segment of the FC.
  • To assess the effectiveness of the StimBurGard in preserving Fallopian canal integrity.

Main Methods:

  • Prospective clinical trial involving 35 patients undergoing translabyrinthine (TL) approach for vestibular schwannoma removal.
  • Patients were divided into three groups to evaluate different stimulation parameters and their correlation with FC exposure and integrity.

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  • Postoperative CT scans were used to assess Fallopian canal thickness and dehiscence, compared with surgical observations.

    • Main Results:

    • Stimulation at 2 mA was required near the Fallopian canal (FC) in Group 1.
    • Group 2 showed a mean FC thickness of 1.09 ± 0.69 mm with 2 cases of radiologic dehiscence.
    • Group 3, using routine drilling, had a mean FC thickness of 0.41 ± 0.56 mm with 9 cases of uncovered FN (p = 0.0082); stimulation threshold was 0.6 ± 0.37 mA.

    Conclusions:

    • The StimBurGard system provides safe and effective continuous facial nerve (FN) stimulation and identification during otologic surgery.
    • Maintaining a stimulation intensity of 1 mA is associated with preserved Fallopian canal (FC) integrity in most cases.
    • The device aids in minimizing the risk of FN injury during drilling in proximity to the Fallopian canal.