Intraoperative videomonitoring of the facial nerve

Objective: To propose the application of an intraoperative videomonitoring system in otologic and otoneurologic surgery. The authors also compare results obtained by using this system with findings deriving from electromyography and pneumosensorial monitoring methods. Study Design: The single-subject design study, involving six patients with middle ear or otoneurosurgery, compares reliability of different monitoring procedures, especially in terms of advantages and drawbacks. Setting: Video system versus electrophysiologic and pneumosensorial systems. Patients: Two patients affected with chronic otitis media, two from Meniere's disease, and two from Acoustic Neuroma. Interventions: Intraoperative diagnostic and prognostic. Results: Electrophysiologic method shows more sensibility, but is affected by a moderate grade of false positive because of electric artifacts; videomonitoring system showed less sensibility, but appears reliable; pneumosensorial system gives in between results. Conclusions: In intraoperative monitoring techniques, reliability and feasibility are the most important factors and are achieved, in this study, by the videomonitoring system. Video recording of images have permitted further off-line analysis.