Facial Nerve Intraoperative Monitoring in Otologic Surgeries under Sedation and Local Anesthesia - A Case Series and Literature Review
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | International Archives of Otorhinolaryngology |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1809-48642020000100003 |
Resumo: | Abstract Introduction Local anesthesia with sedation has been employed for an increasingly number of otolaryngology procedures, and might be associated with lower surgical morbidity and costs. Facial nerve monitoring is often advisable in otology to minimize the risks of injuries to this cranial nerve, but the principles, techniques and parameters involved have only been studied for procedures under general anesthesia. Objective To report the preliminary outcomes of intraoperative facial nerve moni- toring during otologic procedures under sedation and local anesthesia. Methods A total of five procedures and their respective intraoperative electrophysi- ological main findings were described. Facial neuromonitoring was performed using the same device by an electrophysiologist. The monitor sensitivity was set at 100 mV, and a stimulating probe was used whenever needed. Results Progressively decreasing low-amplitude baseline values were usually obtained as the level of anesthesia increased, with isolated oscillations possibly related to some degree of voluntary muscular activity. These oscillations could be easily distinguished from those of the surgical manipulation or electrical stimulation of the nerve, which tended to be of much greater amplitude and shorter latency, occurring during specific surgical steps. Conclusion With a surgical team with proper procedural knowledge and broad expertise regarding the technique, intraoperative facial nerve monitoring under local anesthesia with sedation seemed both feasible and reliable. Thus, the need for intraoperative neuromonitoring should not be an obstacle for otologic procedures under less aggressive anesthetic management. |
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Facial Nerve Intraoperative Monitoring in Otologic Surgeries under Sedation and Local Anesthesia - A Case Series and Literature Reviewfacial nervelocal anesthesiaotologic surgical proceduresAbstract Introduction Local anesthesia with sedation has been employed for an increasingly number of otolaryngology procedures, and might be associated with lower surgical morbidity and costs. Facial nerve monitoring is often advisable in otology to minimize the risks of injuries to this cranial nerve, but the principles, techniques and parameters involved have only been studied for procedures under general anesthesia. Objective To report the preliminary outcomes of intraoperative facial nerve moni- toring during otologic procedures under sedation and local anesthesia. Methods A total of five procedures and their respective intraoperative electrophysi- ological main findings were described. Facial neuromonitoring was performed using the same device by an electrophysiologist. The monitor sensitivity was set at 100 mV, and a stimulating probe was used whenever needed. Results Progressively decreasing low-amplitude baseline values were usually obtained as the level of anesthesia increased, with isolated oscillations possibly related to some degree of voluntary muscular activity. These oscillations could be easily distinguished from those of the surgical manipulation or electrical stimulation of the nerve, which tended to be of much greater amplitude and shorter latency, occurring during specific surgical steps. Conclusion With a surgical team with proper procedural knowledge and broad expertise regarding the technique, intraoperative facial nerve monitoring under local anesthesia with sedation seemed both feasible and reliable. Thus, the need for intraoperative neuromonitoring should not be an obstacle for otologic procedures under less aggressive anesthetic management.Fundação Otorrinolaringologia2020-03-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1809-48642020000100003International Archives of Otorhinolaryngology v.24 n.1 2020reponame:International Archives of Otorhinolaryngologyinstname:Fundação Otorrinolaringologia (FORL)instacron:FORL10.1055/s-0039-1697991info:eu-repo/semantics/openAccessMangia,Lucas Resende LucinadaSantos,Vanessa MazanekMansur,Thaisa MunizWiemes,Gislaine Richter MinhotoHamerschmidt,Rogerioeng2020-02-11T00:00:00Zoai:scielo:S1809-48642020000100003Revistahttps://www.scielo.br/j/iao/https://old.scielo.br/oai/scielo-oai.php||iaorl@iaorl.org||archives@internationalarchivesent.org||arquivos@forl.org.br1809-48641809-4864opendoar:2020-02-11T00:00International Archives of Otorhinolaryngology - Fundação Otorrinolaringologia (FORL)false |
dc.title.none.fl_str_mv |
Facial Nerve Intraoperative Monitoring in Otologic Surgeries under Sedation and Local Anesthesia - A Case Series and Literature Review |
title |
Facial Nerve Intraoperative Monitoring in Otologic Surgeries under Sedation and Local Anesthesia - A Case Series and Literature Review |
spellingShingle |
Facial Nerve Intraoperative Monitoring in Otologic Surgeries under Sedation and Local Anesthesia - A Case Series and Literature Review Mangia,Lucas Resende Lucinada facial nerve local anesthesia otologic surgical procedures |
title_short |
Facial Nerve Intraoperative Monitoring in Otologic Surgeries under Sedation and Local Anesthesia - A Case Series and Literature Review |
title_full |
Facial Nerve Intraoperative Monitoring in Otologic Surgeries under Sedation and Local Anesthesia - A Case Series and Literature Review |
title_fullStr |
Facial Nerve Intraoperative Monitoring in Otologic Surgeries under Sedation and Local Anesthesia - A Case Series and Literature Review |
title_full_unstemmed |
Facial Nerve Intraoperative Monitoring in Otologic Surgeries under Sedation and Local Anesthesia - A Case Series and Literature Review |
title_sort |
Facial Nerve Intraoperative Monitoring in Otologic Surgeries under Sedation and Local Anesthesia - A Case Series and Literature Review |
author |
Mangia,Lucas Resende Lucinada |
author_facet |
Mangia,Lucas Resende Lucinada Santos,Vanessa Mazanek Mansur,Thaisa Muniz Wiemes,Gislaine Richter Minhoto Hamerschmidt,Rogerio |
author_role |
author |
author2 |
Santos,Vanessa Mazanek Mansur,Thaisa Muniz Wiemes,Gislaine Richter Minhoto Hamerschmidt,Rogerio |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Mangia,Lucas Resende Lucinada Santos,Vanessa Mazanek Mansur,Thaisa Muniz Wiemes,Gislaine Richter Minhoto Hamerschmidt,Rogerio |
dc.subject.por.fl_str_mv |
facial nerve local anesthesia otologic surgical procedures |
topic |
facial nerve local anesthesia otologic surgical procedures |
description |
Abstract Introduction Local anesthesia with sedation has been employed for an increasingly number of otolaryngology procedures, and might be associated with lower surgical morbidity and costs. Facial nerve monitoring is often advisable in otology to minimize the risks of injuries to this cranial nerve, but the principles, techniques and parameters involved have only been studied for procedures under general anesthesia. Objective To report the preliminary outcomes of intraoperative facial nerve moni- toring during otologic procedures under sedation and local anesthesia. Methods A total of five procedures and their respective intraoperative electrophysi- ological main findings were described. Facial neuromonitoring was performed using the same device by an electrophysiologist. The monitor sensitivity was set at 100 mV, and a stimulating probe was used whenever needed. Results Progressively decreasing low-amplitude baseline values were usually obtained as the level of anesthesia increased, with isolated oscillations possibly related to some degree of voluntary muscular activity. These oscillations could be easily distinguished from those of the surgical manipulation or electrical stimulation of the nerve, which tended to be of much greater amplitude and shorter latency, occurring during specific surgical steps. Conclusion With a surgical team with proper procedural knowledge and broad expertise regarding the technique, intraoperative facial nerve monitoring under local anesthesia with sedation seemed both feasible and reliable. Thus, the need for intraoperative neuromonitoring should not be an obstacle for otologic procedures under less aggressive anesthetic management. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-03-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1809-48642020000100003 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1809-48642020000100003 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1055/s-0039-1697991 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Fundação Otorrinolaringologia |
publisher.none.fl_str_mv |
Fundação Otorrinolaringologia |
dc.source.none.fl_str_mv |
International Archives of Otorhinolaryngology v.24 n.1 2020 reponame:International Archives of Otorhinolaryngology instname:Fundação Otorrinolaringologia (FORL) instacron:FORL |
instname_str |
Fundação Otorrinolaringologia (FORL) |
instacron_str |
FORL |
institution |
FORL |
reponame_str |
International Archives of Otorhinolaryngology |
collection |
International Archives of Otorhinolaryngology |
repository.name.fl_str_mv |
International Archives of Otorhinolaryngology - Fundação Otorrinolaringologia (FORL) |
repository.mail.fl_str_mv |
||iaorl@iaorl.org||archives@internationalarchivesent.org||arquivos@forl.org.br |
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1754203976558968832 |