{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T14:42:06Z","timestamp":1777992126517,"version":"3.51.4"},"reference-count":35,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2013,3,15]],"date-time":"2013-03-15T00:00:00Z","timestamp":1363305600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives\/Hypothesis<\/jats:title>\n                    <jats:p>To evaluate percent maximum as an intraoperative facial nerve measurement for the long\u2010term prognostication of vestibular schwannoma surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Evoked amplitude responses to varying levels of stimulus intensity at the nerve root were compared to their supramaximal responses (Mmax) as a percentage, that is, percent maximum. Response charts were constructed for each of the levels of stimulus intensity between 0.05 to 0.3 mA, vis\u2010\u00e0\u2010vis facial nerve outcome at 1 year, to establish sensitivities, specificities, and positive predictive values. Logistic regression analyses were used to determine the impact of sex, age, tumor size, and historically defined response parameter on outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventy\u2010eight patients who underwent vestibular schwannoma surgeries between 2005 and 2010 were studied. The positive predictive value (PPV) of a good facial nerve outcome, defined as House\u2010Brackmann (HB) I\u2010II, increases with percent maximum responses. A 90% PPV could be established when the response amplitude was 50% or greater compared to Mmax. Long\u2010term prognostication appeared best at a higher stimulus level of 0.3 mA. Age and sex did not have an impact on outcome, but tumor size did; with each centimeter increase in tumor size, patients were 105% more likely to have a poor outcome (HB III\u2010VI). If the response parameter \u201c\u2265240 \u03bcV at 0.05 mA\u201d was not present, there was a trend toward poor outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Percent maximum is a valid intraoperative monitoring measure to prognosticate long\u2010term facial nerve outcome. It should be considered a complementary method of monitoring when evoked responses do not conform to conventional predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      4.\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 123:2533\u20132538, 2013\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.24083","type":"journal-article","created":{"date-parts":[[2013,3,15]],"date-time":"2013-03-15T15:35:19Z","timestamp":1363361719000},"page":"2533-2538","source":"Crossref","is-referenced-by-count":12,"title":["Facial nerve prognostication in vestibular schwannoma surgery: The concept of percent maximum and its predictability"],"prefix":"10.1002","volume":"123","author":[{"given":"Christoph","family":"Arnoldner","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\/Head and Neck Surgery Sunnybrook Health Sciences Centre University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Mick","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\/Head and Neck Surgery Sunnybrook Health Sciences Centre University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farhad","family":"Pirouzmand","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Neurosurgery Sunnybrook Health Sciences Centre University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Houlden","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Neurosurgery Sunnybrook Health Sciences Centre University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent Y. 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