{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:50:15Z","timestamp":1792003815262,"version":"4.4.0"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:p>Despite the widespread acceptance of intraoperative neurophysiological monitoring in skull base surgery over the last 2 decades, surgeon training in the technical and interpretive aspects of nerve monitoring has been conspicuously lacking. Inadequate fundamental knowledge of neurophysiological monitoring may lead to misinterpretations and an inability to troubleshoot system errors. Some surgeons perform both the technical and interpretive aspects of monitoring themselves while others enjoin coworkers (surgical residents, nurses, anesthetists, or a separate monitoring service) to perform the technical portion. Regardless, the surgeon must have a thorough understanding to avoid potential medical and legal pitfalls because poor monitoring is worse than no monitoring. A structured curriculum and protocol in both the technical and interpretive aspects of monitoring is recommended for all personnel involved in the monitoring process. This paper details the technical, interpretive, and surgical correlates necessary for optimal intraoperative nerve monitoring during vestibular schwannoma surgery with an emphasis on electromyographic monitoring for facial and recurrent laryngeal nerves. Just as the American Society of Anesthesiologists' 1986 \u201cStandards for Basic Anesthetic Monitoring\u201d became a useful tool for both patients and anesthesiologists, impending guidelines in intraoperative neurophysiological monitoring should likewise become an important instrument for optimizing intraoperative neurophysiological monitoring.<\/jats:p>","DOI":"10.3171\/2012.7.focus12196","type":"journal-article","created":{"date-parts":[[2012,9,1]],"date-time":"2012-09-01T12:14:35Z","timestamp":1346501675000},"page":"E5","source":"Crossref","is-referenced-by-count":37,"title":["Pitfalls in intraoperative nerve monitoring during vestibular schwannoma surgery"],"prefix":"10.3171","volume":"33","author":[{"given":"Matthew L.","family":"Kircher","sequence":"first","affiliation":[{"name":"Michigan Ear Institute, Farmington Hills, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack M.","family":"Kartush","sequence":"additional","affiliation":[{"name":"Michigan Ear Institute, Farmington Hills, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0330005","series-title":"Eur Arch Otorhinolaryngol","first-page":"120","article-title":"Fallopian canal dehiscences: a survey of clinical and anatomical findings","volume":"262","author":"Di Martino","year":"2005"},{"key":"b2-0330005","series-title":"Am J Otol","first-page":"1","article-title":"A comparison of facial nerve monitoring systems in cerebellopontine angle surgery","volume":"12","author":"Dickins","year":"1991"},{"key":"b3-0330005","series-title":"AANA J","first-page":"111","article-title":"Case study involving suctioning of an electromyographic endotracheal tube","volume":"73","author":"Evanina","year":"2005"},{"key":"b4-0330005","series-title":"Mayo Clin Proc","first-page":"92","article-title":"Improved preservation of facial nerve function with use of electrical monitoring during removal of acoustic neuromas","volume":"62","author":"Harner","year":"1987"},{"key":"b5-0330005","series-title":"Am J Otol","first-page":"649","article-title":"Vagal nerve monitoring in surgery of the skull base: a comparison of efficacy of three techniques","volume":"20","author":"Jackson","year":"1999"},{"key":"b6-0330005","series-title":"Otolaryngol Head Neck Surg","first-page":"496","article-title":"Electroneurography and intraoperative facial monitoring in contemporary neurotology","volume":"101","author":"Kartush","year":"1989"},{"key":"b7-0330005","series-title":"Neuromonitoring in Otology and Head and Neck Surgery","first-page":"99","article-title":"Intraoperative facial nerve monitoring: otology, neurotology and skull base surgery","year":"1992"},{"key":"b8-0330005","series-title":"Otolaryngol Clin North Am","first-page":"623","article-title":"Facial nerve outcome in acoustic neuroma surgery","volume":"25","author":"Kartush","year":"1992"},{"key":"b9-0330005","series-title":"Laryngoscope","first-page":"1536","article-title":"Intraoperative facial nerve monitoring: a comparison of stimulating electrodes","volume":"95","author":"Kartush","year":"1985"},{"key":"b10-0330005","series-title":"Otolaryngol Head Neck Surg","first-page":"814","article-title":"Facial nerve monitoring in acoustic tumor surgery","volume":"104","author":"Kwartler","year":"1991"},{"key":"b11-0330005","series-title":"J Laryngol Otol","first-page":"557","article-title":"Facial nerve monitoring in skull base surgery","volume":"108","author":"Magliulo","year":"1994"},{"key":"b12-0330005","series-title":"Laryngoscope","first-page":"2295","article-title":"Facial nerve outcome with a peroperative stimulation threshold under 0.05 mA","volume":"121","author":"Marin","year":"2011"},{"key":"b13-0330005","series-title":"Acoustic Neuroma. 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