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The optimal and safe intensity for facial nerve stimulation during intraoperative neuromonitoring in middle ear surgery
OBJECTIVE: This study aimed to investigate the optimal and safe intensity for facial nerve stimulation during middle ear surgery. METHODS: Thirty-seven patients who had their facial nerve exposed prior to surgery were prospectively enrolled in this study, and electromyography (EMG) recordings were o...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6715191/ https://www.ncbi.nlm.nih.gov/pubmed/31465477 http://dx.doi.org/10.1371/journal.pone.0221748 |
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author | Park, Euyhyun Kim, Hyunjung Han, Hye Min Choi, In Hak Jung, Hak Hyun Im, Gi Jung |
author_facet | Park, Euyhyun Kim, Hyunjung Han, Hye Min Choi, In Hak Jung, Hak Hyun Im, Gi Jung |
author_sort | Park, Euyhyun |
collection | PubMed |
description | OBJECTIVE: This study aimed to investigate the optimal and safe intensity for facial nerve stimulation during middle ear surgery. METHODS: Thirty-seven patients who had their facial nerve exposed prior to surgery were prospectively enrolled in this study, and electromyography (EMG) recordings were obtained from the orbicularis oculi and orbicularis oris muscles. Four pigs were also enrolled in an animal study, and continuous stimulation was performed on the facial nerves of the pigs for 10 minutes. The EMG responses were measured and the pathologic outcomes of the facial nerve after stimulation were determined. RESULTS: In the human study, the mean intensity of the minimal electrical stimulation threshold was 0.21 mA (range: 0.1–0.3 mA). A linear correlation was observed between stimulus intensity and response amplitude for intensities below 0.4 mA. Response amplitudes reached a plateau between 0.4 mA and 1.0 mA. The minimal stimulus intensity that could generate a maximal response was 0.4 mA in the orbicularis oculi (244 μV) and orbicularis oris (545 μV). In the animal study, there were no observed changes in EMG or nerve damage incidence after the continuous stimulation of 3.0 mA. CONCLUSIONS: 0.4 mA is considered to be the optimal intensity of facial nerve stimulation during middle ear surgery, and it was estimated through the animal study that a stimulation of 3.0 mA is safe from facial nerve damage. |
format | Online Article Text |
id | pubmed-6715191 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-67151912019-09-10 The optimal and safe intensity for facial nerve stimulation during intraoperative neuromonitoring in middle ear surgery Park, Euyhyun Kim, Hyunjung Han, Hye Min Choi, In Hak Jung, Hak Hyun Im, Gi Jung PLoS One Research Article OBJECTIVE: This study aimed to investigate the optimal and safe intensity for facial nerve stimulation during middle ear surgery. METHODS: Thirty-seven patients who had their facial nerve exposed prior to surgery were prospectively enrolled in this study, and electromyography (EMG) recordings were obtained from the orbicularis oculi and orbicularis oris muscles. Four pigs were also enrolled in an animal study, and continuous stimulation was performed on the facial nerves of the pigs for 10 minutes. The EMG responses were measured and the pathologic outcomes of the facial nerve after stimulation were determined. RESULTS: In the human study, the mean intensity of the minimal electrical stimulation threshold was 0.21 mA (range: 0.1–0.3 mA). A linear correlation was observed between stimulus intensity and response amplitude for intensities below 0.4 mA. Response amplitudes reached a plateau between 0.4 mA and 1.0 mA. The minimal stimulus intensity that could generate a maximal response was 0.4 mA in the orbicularis oculi (244 μV) and orbicularis oris (545 μV). In the animal study, there were no observed changes in EMG or nerve damage incidence after the continuous stimulation of 3.0 mA. CONCLUSIONS: 0.4 mA is considered to be the optimal intensity of facial nerve stimulation during middle ear surgery, and it was estimated through the animal study that a stimulation of 3.0 mA is safe from facial nerve damage. Public Library of Science 2019-08-29 /pmc/articles/PMC6715191/ /pubmed/31465477 http://dx.doi.org/10.1371/journal.pone.0221748 Text en © 2019 Park et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Park, Euyhyun Kim, Hyunjung Han, Hye Min Choi, In Hak Jung, Hak Hyun Im, Gi Jung The optimal and safe intensity for facial nerve stimulation during intraoperative neuromonitoring in middle ear surgery |
title | The optimal and safe intensity for facial nerve stimulation during intraoperative neuromonitoring in middle ear surgery |
title_full | The optimal and safe intensity for facial nerve stimulation during intraoperative neuromonitoring in middle ear surgery |
title_fullStr | The optimal and safe intensity for facial nerve stimulation during intraoperative neuromonitoring in middle ear surgery |
title_full_unstemmed | The optimal and safe intensity for facial nerve stimulation during intraoperative neuromonitoring in middle ear surgery |
title_short | The optimal and safe intensity for facial nerve stimulation during intraoperative neuromonitoring in middle ear surgery |
title_sort | optimal and safe intensity for facial nerve stimulation during intraoperative neuromonitoring in middle ear surgery |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6715191/ https://www.ncbi.nlm.nih.gov/pubmed/31465477 http://dx.doi.org/10.1371/journal.pone.0221748 |
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