ENT/OM Surgery
Neuromonitoring in ENT/OM surgery
In Ear, Nose, and Throat (ENT) surgeries, especially those involving the cranial base and delicate structures around the head and neck, neuromonitoring is crucial for preserving vital neural functions. like acoustic neuroma surgery.
The Situation
Neuromonitoring in ENT and OM surgery
While parotid gland tumours are less prevalent compared to other types, UK sees thousands of surgeries annually to either partially or completely remove the parotid gland. The risk of damaging delicate facialis nerve branches during these procedures is considerable. Even minor damage to these structures can result in severe consequences for patients, such as inability to close an eyelid or drooping of the mouth corner, taste alterations, and reduced tear and saliva secretion, impacting their psychological well-being significantly.

Fields of application
Facial nerve identification and function assessment during parotid surgery, mastoidectomy, cochlear implant insertion, and middle ear surgery.
Cranial motor nerve monitoring during tumour removal in oral, ear, neck, nasal, and skull base surgeries.

Monitoring the facialis nerve
Functionality
In intraoperative neuromonitoring, specialized stimulation probes transmit small electric impulses to the nerves. These impulses travel to corresponding facial muscles, where electromyography (EMG) measures muscle action potential, converting it into visual or auditory signals.
Four distinct-coloured EMG signal graphs depict the functioning of main facialis nerve branches, detecting even the slightest nerve irritation. Any inadvertent pressure, traction, stretching, or compression of a nerve prompts spontaneous muscle contraction, which AVALANCHE® SI detects and alerts through acoustic or visual cues.
Bipolar and monopolar stimulation
Just a little twitch is often enough
For certain surgeries, a straightforward method of monitoring neural function suffices. A noticeable twitch in the target muscle upon nerve stimulation indicates normal function. An assistant can observe this response, allowing the surgeon to focus solely on the surgical site while ensuring sensory structure integrity. Simultaneously connecting two stimulation probes, such as bipolar and monopolar, can be beneficial in this regard.

VANESSA Headbox
The headbox conveniently attaches to the operating table and features two stimulation ports, allowing seamless use of both monopolar and bipolar stimulation without the need to switch probes.

AEP Measuring
To assess the auditory pathway
Enhance your AVALANCHE® SI with an auditory evoked potentials (AEP) measuring system, crucial for surgeries prioritizing auditory function. Combining EMG and AEP in one portable neuromonitor is a truly unparalleled feature!

Stimulation Probe
Electric stimulation of nerves and neuronal structures
Choose from Bipolar or Monopolar, Fork-tipped, Ball-tipped, we offer a variety of probes tailored to your needs. We’re here to guide you through the benefits and usage of each type.
Our comprehensive range caters to almost every scenario, with stimulation probes crafted with ergonomic precision.
Crafted in Germany with meticulous attention to detail by Dr. Langer Medical, ensuring quality you can trust.

Needle Electrodes
Colour-coded needle electrodes for recording and stimulation
Whether you require single or multiple channels for recording EMG or EP signals, or need to stimulate nerves and muscular tissue, Dr. Langer Medical GmbH offers a wide range of needle electrodes for neuromonitoring.
Choose from various lengths, shapes, geometric arrangements, and a selection of colours tailored to your specific application needs – the options are abundant.