Learning from Anaesthetists: A Technique for Safe and Effective Facial Nerve Monitoring

To develop a technique to reliably secure facial nerve monitoring electrodes, NeurosignTM facial nerve monitor electrodes were attached as per the manufacturer’s instructions. The electrodes were secured with ½ inch steristripsTM before connecting leads were brought to the contralateral side of the face and a single torque loop was created and secured with either more Steri-StripsTM, Micropore tapeTM, or a TegedermTM. By creating a single torque loop, a buffer between the electrode and its anchor point to the contralateral face was formed. This allowed for the secure attachment of leads from the electrodes by removing tension, thereby reducing the likelihood of displacement. We have used this technique successfully for the last three years in over 50 parotid procedures and 50 middle ear explorations. Facial nerve monitoring is an important surgical tool used in otology and head and neck surgery. Using torque loops when preparing a patient for surgery prevents the dislodgement of electrodes during operation, thereby ensuring the safety of the patient in a sometimes perilous environment.