Enhanced Precision in Personalized Intraoperative Monitoring of Facial Nerves: A Comparative Analysis of Functional MRI-Guided and Conventional Electrode Placement for Transcranial Motor-Evoked Potentials During Skull Base Surgery

Key Points

• This research aims to compare the efficacy of fMRI-guided electrode placement versus conventional methods for monitoring facial nerves during surgery.
• Compared fMRI-guided tfMEP with conventional electrode placement at C3/C4.
• Monitored stimulation thresholds and threshold drift after CSF loss.
• Evaluated workflow for intraoperative decision-making regarding facial nerve preservation.
• fMRI-guided placement significantly lowers stimulation thresholds compared to conventional methods.
• No increase in threshold drift associated with fMRI guidance after CSF loss.
• Suggests improved precision and reliability in monitoring facial nerves.