[Intraoperative facial nerve monitoring. Practical remarks].

Objective: Even the most experienced surgeon may have difficulties in identifying and preserving the facial nerve, particularly when the operation is complicated, for example, by size and localization of tumour, trauma or anatomic variations. The aim of this study is to present indications, technics and interpretation of intraoperative facial nerve monitoring.

Methods: This study bases on literature review and our own experience in intraoperative facial nerve monitoring.

Conclusions: Intraoperative facial nerve monitoring is helpful during excision of large and middle size acoustic neuromas, because preservation of facial nerve function improves with use of electrical monitoring. Intraoperative monitoring during other kinds of operation, which are likely to impact on the facial nerve may also be of benefit. This however, is hardly proved in the literature. Its seems, that electrical intraoperative monitoring is more sensitive than pneumatic motion detector system. Intraoperative monitoring is an adjunct, not replacement, to surgeon's experience and ability. The presence or absence of facial evoked responses must be interpreted within the context of surgical procedure, bearing in mind possibility the of false-positive and false-negative errors.