Stimulation electromyography as a method of intraoperative localization and identification of the facial nerve during parotidectomy: review of 15 consecutive parotid surgeries

Abstract

Introduction: It has been widely recognized that one of the major hazards during operation of the parotid gland, mainly in tumor resection, is the injury of the facial nerve. Facial nerve monitoring has achieved wide application in otologic and neurotologic procedures to help localization and protection of the facal nerve in the temporal bone.

Material and methods: The authors analyze localization and identification of 15 nerves in 15 patients who underwent parotid gland surgery in the Department of Ear Nose and Throat Diseases of the Medical University in Plovdiv from September 15, 2000 to December 15, 2000. Nerve integrity monitor Neurosign 100 and specially designed electromyographic electrodes were used.

Results: In all patients stimulation electromyography of the facial nerve was successfully used to locate, identify and evaluate the integrity of the facial nerve during and at the end of the operation. No postoperative facial nerve injury was detected clinically. In two patients with parotid gland cancer the inferior division of the facial nerve was found infiltrated by the cancer growth.

Conclusion: The results indicate that identification of the facial nerve by electromyography is a safe, effective and simple method of electrophysiologic monitoring during parotid gland surgery. This method allows assessment of the nerve integrity at the end of the operation.