India's First Non-contact Low-Cost Facial Nerve Monitor for Micro Ear Surgery: A Step Toward Affordable Healthcare Solutions.

To assess the effectiveness of a newly designed, non-contact facial nerve monitor as a cost-efficient alternative to conventional nerve monitors with facial electrodes, particularly under local anesthesia, without compromising patient safety or outcomes. Pilot study involving 49 patients aged 3-59 years, who underwent otologic surgery from December 2023 to September 2024. Five patients underwent surgery monitored by both the non-contact device and the Medtronic NIM-2, allowing comparative analysis. After calibration to industry standards, the non-contact monitor was tested on 44 additional patients, and used alone to identify the facial nerve's location and bone depth. In this study, all enrolled patients were confirmed to have no pre- operative facial palsy/paresis, establishing a uniform baseline for facial nerve function. The noncontact facial nerve monitor successfully identified the vertical segment of the facial nerve in all patients, demonstrating its reliability in nerve localization. Additionally, the noncontact monitor consistently detected the second genu, even in cases without nerve dehiscence, and accurately traced the entire horizontal segment across all patients. Adjustments in current stimulation with the monitor provided comparable accuracy to existing monitors, allowing for an approximation of bone thickness around the nerve. These results confirm our monitor's effectiveness and compatibility in identifying key facial nerve segments, offering a cost-effective and affordable alternative. Our non-contact facial nerve monitor provides a practical, affordable alternative to traditional systems, effectively identifying critical nerve segments and bone depth under a microscope. It is suitable for small private and government healthcare settings, addressing the need for accessible, low-cost surgical tool.