A new integrated system for neural stimulation and bipolar coagulation: preliminary study

Abstract

Conclusion. Tthe proposed device can be useful for promoting safety during bipolar coagulation in many surgical procedures and/or regions. Objective. A new system that integrates a neural stimulator and a bipolar coagulator is proposed, to improve neural (facial nerve) safety during ENT surgical procedures. This study aimed to evuate the system. Materials and methods. A home-made constant current neural stimulator (0.1–2 mA, pulsed, duration 200 µs), was connected via an automatic switch to a commercial bipolar microcoagulator (Medicon Instrumente mod. 101, Germany). Under general anesthesia, the extra-petrous portion of the facial nerve was identified in three rabbits. The adequate functioning of the device was tested via: 1) neural stimulation and EMG monitoring in basal conditions; 2) bipolar coagulation of connective tissue surrounding the facial nerve; 3) final assessment of the functional integrity of the nerve, via an intraoperative EMG and a postoperative evaluation. Results. Data obtained from all three rabbits provided adequate results in terms of neural stimulation, correct coagulation of juxta-nervous tissue, and functional integrity of the facial nerve, both intraoperatively and postoperatively.

• Facial nerve
• monitoring
• facial palsy
• bipolar coagulation
• otoneurosurgery