INTRAOPERATIVE MONITORING IN ACOUSTIC NEUROMA SURGERY

Intra-operative neurophysiologic monitoring (IOM) is rapidly evolving as an important adjunct during acoustic neuroma surgery to reduce the incidence of neurologic deficits. Monitoring alerts the surgeon to ong oing changes in neural function. The benefit of facial nerve monitorin g in reducing the incidence of facial palsy during acoustic tumor rese ction appears clear and is now recommended by the National Institutes of Health (Consensus Development Conference on Acoustic Neuroma, 1991) . Auditory monitoring is not as effective as facial monitoring but hea ring preservation can be enhanced particularly ii used with facial mon itoring because the latter alerts the surgeon to traumatic manipulatio ns that may affect both facial and cochlear nerves. Monitoring is not a replacement for surgical experience. 'Poor monitoring is worse than no monitoring'.