Intraoperative facial nerve monitoring (IOFNM) has evolved from requiring sophisticated electromyography equipment to a self-contained monitor with an auditory signal. Subspecialty ear surgeons currently use IOFNM in most otologic and temporal bone procedures as it improves facial nerve outcomes. Our competency and near-universal adoption of IOFNM notwithstanding, otolaryngologists are rarely reimbursed for this procedure. Subspecialists value this technology as medically necessary and should importune fair reimbursement for their expertise in this procedure that is so vital to patient safety.
RuhlDSHongSSLittlefieldPD. Lessons learned in otologic surgery: 30 years of malpractice cases in the United States. Otol Neurotol. 2013;34:1173-1179.
2.
DelgadoTEBucheitWARosenholtzHRChrissianS. Intraoperative monitoring of facial muscle evoked responses obtained by intracranial stimulation of the facial nerve: a more accurate technique for facial nerve dissection. Neurosurgery. 1979;4:418-421.
3.
GidleyPMawJGantzBet al. Contemporary opinions on intraoperative facial nerve monitoring. OTO Open. In press.
4.
RolandPSMeyerhoffWL. Intraoperative electrophysiological monitoring of the facial nerve: is it standard of practice?Am J Otolaryngology. 1994;15:267-270.
