Facial motor evoked potentials monitoring during AN surgery

[mk]

In addition to the EMG monitoring of the facial nerve signals during AN surgery, which is common practice, I wonder how common it is for surgeons to monitor the electric motor-evoked potentials of the facial nerve. I bumped into this abstract of an article yesterday, published by my team of surgeons.
http://journals.lww.com/neurosurgery/Abstract/2005/07001/Localized_Transcranial_Electrical_Motor_Evoked.12.aspx
Apparently this technique results in very good outcomes for the facial nerve, as they also explained to me during my consults. I know from my surgical report that they did apply it during my surgery.
Has anyone else heard of this technique being implemented elsewhere?

Marianna

[CHD63]

Before my surgery two weeks ago, the pre-op tech told me I would have electrodes all over my face during surgery so as not to be concerned when I woke up if there were tiny red marks on my face.  I need to dig out my surgical report (still packed!!) to see if I had both types of monitoring or not.  Interesting.

I had a very tiny bit of facial weakness post-op that was really only noticeable when I grinned and by my feeling like I had a burning thread across my lower left lip and that is virtually gone now.

Clarice

[nftwoed]

Hi;

  I thought facial nerve evoked potentials were monitored in every AN surgery?

[leapyrtwins]

Interesting article.

I don't know the specifics, but I do know my facial nerve was monitored during my surgery.

I think that's pretty standard among docs these days.

Jan

[mk]

EMG monitoring of the nerves is indeed standard. However this is different - in addition to the standard monitoring, it involves nerve stimulation. I had never heard about this before, so this is why I wonder if it is common practice as well.

Clarice, I still have the red marks on my right cheek. I would be very interested to know if HEI uses nerve stimulation.

Marianna

[CHD63]

Marianna .....

Throughout Dr. Schwartz' surgical report, he talks about the facial nerve stimulator, so I am taking this to mean they did use the nerve stimulation in addition to the standard EMG monitoring.  I had a general rash on my cheek and chin after surgery, but did not specifically notice the red marks they told me I might have.

When I read the surgical report about all the scar tissue he ran into and all of the working around the facial nerve to remove the tumor he had to do, I am amazed that I emerged with an intact facial nerve.

By the way, House has all of their AN surgical patients take Famciclovir from three days before surgery till ten days after surgery ...... supposedly to lessen the chance of delayed facial weakness.  See http://www.ncbi.nlm.nih.gov/pubmed/18596563

So very, very grateful!!

Clarice

[mk]

Clarice, this is interesting. I was also prescribed an antibiotic, which I had to take the night before surgery, and to continue for 10 days. It was a different kind though, Minocyclin. They explained to me that research has shown that it has some protective activity for the facial nerve.

Reading the surgery report can be overwhelming, because it makes you realize the degree of difficulty that the surgeons have to go through. In my case they did have to leave a tiny piece that was stuck to the facial nerve inside the IAC, because the EMG signals indicated that doing otherwise might damage the nerve.

Marianna