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December 1991

Monitoring the Facial Nerve During Parotidectomy

Author Affiliations

Erie, Pa; Cologne, Germany

Arch Otolaryngol Head Neck Surg. 1991;117(12):1420. doi:10.1001/archotol.1991.01870240112022

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To the Editor.—Parotidectomy with preservation of the facial nerve is a procedure commonly performed by many otolaryngologists. While there are a variety of techniques for performing a parotidectomy, the techniques to monitor the facial nerve during this surgery have received little emphasis. Since 1988, we have been using a specific nerve monitor (Nerve Integrity Monitor II ([NIM II], Xomed, Jacksonville, Fla) to intraoperatively monitor facial muscle electromyographic signals via needle electrodes placed within specific muscles of the face.

The patient is prepared and draped in the usual fashion for parotidectomy. Once the sterile field is established, the needle electrodes are placed into the orbicularis oculi muscles as well as in the region of the orbicularis oris muscle. This takes only a few minutes to do. Ground electrodes are also placed. Once a baseline electromyogram is obtained, any muscle stimulus will subsequently be displayed on the viewing screen as a

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