2025 Poster Presentations
P471: CURRENT STATE OF INTRAOPERATIVE NEUROMONITORING OF THE FACIAL NERVE DURING SKULL BASE SURGERY: A SCOPING REVIEW
Jihad Abdelgadir, MD1; Tanner J Zachem, BSE1; Syed M Adil, MD1; Jordan K Hatfield1; Joshua Woo, BS1; Brandon Lee, BS2; Kaela Drummond1; Emma Schlumbom1; Samantha Kaplan, PhD1; Ralph A Hachem, MD1; Patrick J Codd, MD1; Ali Zomorodi, MD1; Rory Goodwin, MD, PhD1; 1Duke University; 2University of North Carolina
Introduction: Skull base surgery inherently requires meticulous work in tight regions surrounded by critical neurovascular structures. Intraoperative electrophysiological neuromonitoring (IONM) is frequently used to ensure patient safety during dissection and manipulation of this delicate anatomy. Many different IONM techniques exist, including triggered electromyography (EMG), free running EMG, reflex arc stimulations, and direct monopolar stimulation; among these different modalities, there is variance in specific technologies, tools, and protocols. The wide variety of strategies used and large amounts of data collected in skull base surgery leads to a vast corpus of knowledge in disparate areas. We present a systematic review of intraoperative neuromonitoring to allow for an overview of the standard of care and identify gaps for future innovation.
Methods: A systematic literature review was conducted using Medline, Embase, and Scopus databases following PRISMA-ScR guidelines to select studies that examined intraoperative neuromonitoring in skull base surgery. Studies that mentioned “intraoperative neuromonitoring” or “skull base” in their titles or abstracts were included in the screen.
Results: 4856 studies were initially identified for inclusion, 2080 duplicates were identified and removed. The remaining 2776 underwent abstract screening. Full text screening and extraction will be conducted after abstract screening is finalized.
Conclusion: IONM enables improvement in outcomes after skull base surgery, and the specific techniques used are numerous and diverse. This review explores these ideas in depth, laying the groundwork for future work in specific modalities that target current gaps. The forthcoming thorough analysis of the full text extraction will yield actionable insights for next steps in innovating skull base neuromonitoring.