To monitor or not to monitor
Reviewed by Badr Eldin Mostafa

This is a report on an e-mail based survey of 1249 otologic surgeons on their practice regarding facial nerve monitoring during ear surgery. The response rate was very low (6.6%). The majority of responders (92%) stated that they did not use facial nerve monitoring during stapes surgery, ossiculoplasty or myringoplasty. In cochlear implant surgery 78% monitored the facial nerve. As regards non-cholesteatomatous CSOM, the majority (68%) did not use the monitor. On the other hand, in primary surgery for cholesteatoma, 52% of the responders used the monitor. This proportion rose to 62% in revision cases. For the vast majority (97%) the choice to monitor was based on CT data especially if the lesion was diffuse, near the course of the facial nerve or if a bony dehiscence was suspected. One of the limiting factors for the availability and / or use of facial nerve monitors seems to be economic restraints including the initial and running costs in addition to poor coding for the procedure.

Facial nerve monitoring during middle ear surgery: results of a French survey.
Mazzaschi O, Juvanon J-M, Mondain M, et al.
EUROPEAN REVIEW OF ENT
2014;135(1):11-7.