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Intraoperative nerve monitoring: 2017

Having written the definitive text on laryngeal nerves, Gregory Randolph and Dipti Kamani describe the benefits of intraoperative neural monitoring and, importantly, how to proceed if the nerve is pathologically involved or there is loss of signal. Over the years,...

Hypoglossal nerve stimulation for OSA

Hypoglossal nerve stimulation has been lauded as the great new surgical treatment panacea for obstructive sleep apnoea (OSA). This meta-analysis includes 12 studies with a total of 350 patients, including the five-year follow-up data from the STAR trial which was...

Peripheral nerve reconstruction using cell-enhanced acellular nerve grafts

Autologous nerve grafts are the current gold standard for peripheral nerve reconstruction. This systematic review analyses the role of cell-enhanced acellular nerve (ANA) grafts on the regeneration of peripheral nerve injuries. Several studies have been published to examine alternatives to...

Direct intratemporal facial nerve to hypoglossal nerve coaptation for facial reanimation

The hypoglossal nerve is a common axonal source for dynamic facial nerve rehabilitation. In its regular and modified forms of splitting the nerve it is associated with tongue hemiatrophy, speech and swallow dysfunction, facial movement and hyper contracture. This case...

Facial nerve anatomy in the temporal bone

Knowledge of the facial nerve anatomy during otological surgery is crucial in avoiding an iatrogenic injury to the facial nerve. In this study, the authors investigated the anatomical relationship between the tympanic portion of the facial canal (FC) and the...

Atlas of the Facial Nerve and Related Structures

Although we all know the course of the facial nerve is pretty complex, I was surprised that a whole book and 104 pages had been dedicated to describing it. However, on reading through the book, it is apparent that although...

Cochlear implants with an absent or hypoplastic cochlear nerve?

The cornerstone of successful cochlear implantation has been the presence of a population of cochlear nerve endings which are able to mount a neural response to electrical stimulation. The authors of this paper present their experience of five children with...

Facial nerve grafting – what’s the wait?

An uninterrupted facial nerve after resection of cerebellopontine angle (CPA) tumour does not always translate into preserved facial animation. Fortunately there is a high probability spontaneous recovery may occur and hence patients are typically observed for 12 months postoperatively. However,...

The middle way: treating idiopathic facial nerve palsy

Whilst the causes of recurrent facial nerve palsy are numerous, in many cases it may be idiopathic. There is no clear consensus on treatment of this condition and conservative management alone may condemn patients to gradually worsening facial nerve function...

Damage to the cochlear nucleus with electrocautery to the cochlear nerve

This study is of importance to neurotologists and neurosurgeons. It is unclear why patients with NF2 have poorer outcomes with an auditory brainstem implant compared to non-tumour patients. This effect is postulated to be due to damage to certain cells...

Is there a role for facial nerve decompression in Ramsay Hunt syndrome?

This is an interesting paper. The authors recommend a transmastoid facial decompression for patients with complete facial nerve paralysis with House Brackman HB 5/6 who do not show any sign of recovery after two weeks of treatment following a diagnosis...

Peripheral nerve stimulation for chronic refractory pain

Peripheral nerve stimulation (PNS) plays an important role in treating chronic refractory pain syndromes that manifest in limited distributions and overlap with areas of neurologic innervation. The process is generally thought to capitalise on the inhibition and activation of pain-related...