Electroneurography and intraoperative facial monitoring in contemporary neurotology.

Electrodiagnostic testing of the facial nerve has evolved beyond prognostic and topognostic testing to include preoperative assessment and intraoperative monitoring. The state of the art in facial nerve testing is herein reviewed. Electroneurography is described as a means of preoperative assessment to detect subclinical neural degeneration for temporal bone tumors, malignant external otitis, and recurring facial paralysis. Techniques of intraoperative facial nerve monitoring are presented with clinical correlation of the facial evoked responses. Finally, recent advances in electrodiagnostic testing, including antidromic recording and transtemporal magnetic stimulation of the facial nerve, are discussed.