Acoustic (loudspeaker) facial electromyographic monitoring: Part 1. Evoked electromyographic activity during acoustic neuroma resection.

A modification of the technique of acoustic facial electromyographic (EMG) monitoring, involving the use of a bipolar wire electrode, was used to monitor facial EMG activity during 13 consecutive unselected acoustic neuroma resections. EMG activity was synchronously recorded on the audio channels of operative video tapes so that the patterns of evoked EMG activity could be analyzed in relation to specific intraoperative events. Despite a relatively wide variety of apparent eliciting mechanisms, evoked EMG activity occurred in only three general acoustic patterns; these were bursts, trains, and pulses. These respective patterns are described in detail and related to specific etiological mechanisms. The possible clinical significance of various patterns of evoked EMG activity is discussed.