Proposals for Standardization of Intraoperative Facial Nerve Monitoring during Parotid Surgery

Area of Science:

• Neurosurgery
• Otolaryngology
• Surgical Oncology

Background:

• Intraoperative facial nerve monitoring (FNM) is crucial in parotid surgery for nerve identification, dissection, and function assessment.
• Current FNM application lacks uniformity, hindering study comparability and limiting the technology's full potential.

Purpose of the Study:

• To review current literature on FNM in parotidectomy.
• To propose standardized FNM procedures to enhance uniformity and quality of application.
• To improve prognostication of facial expression outcomes post-tumor resection.

Main Methods:

• Literature review of existing FNM practices in parotid surgery.
• Development of proposed standards for FNM setup, anesthesia, procedures, stimulus currents, and signal interpretation.
• Inclusion of pre- and post-operative facial expression assessment standards.

Main Results:

• Identified significant variability in current FNM practices.
• Proposed a comprehensive set of standardized procedures for FNM during parotid surgery.
• Established a framework for predicting facial expression outcomes.

Conclusions:

• Standardized FNM procedures are essential for improving consistency and quality in parotid surgery.
• The proposed standards aim to facilitate better comparison of study results and advance future research in FNM.
• Implementing these standards can enhance patient outcomes by optimizing facial nerve protection and function prognostication.