{
  "abstract": "Objective\n\nTo develop a practical, stepwise framework for interpreting intraoperative neurophysiological signals to predict facial nerve outcomes after acoustic neuroma surgery.Methods\n\nThis methodological report synthesizes evidence from three IONM modalities: facial motor evoked potentials (FMEPs), direct electrical stimulation (DES), and free-running electromyography (EMG). Key predictive parameters, threshold values, sensitivity, specificity, and technical limitations were extracted from published meta-analyses, systematic reviews, and prospective cohort studies. These parameters were then organized chronologically into a stepwise interpretation framework according to their typical intraoperative use.Results\n\nAn end-of-surgery FMEP amplitude reduction >50% predicts poor long-term (≥1 year) facial function with 93% specificity. A DES threshold ≤0.05 mA at the brainstem stump predicts good long-term function (73% sensitivity, 74% specificity). A cumulative A-train duration >10 s on free-running EMG signals high risk for severe immediate palsy (66.7% sensitivity, 88.0% specificity). The 2026 CNS guidelines confirm that electrophysiological parameters predict long-term outcomes better than clinical information alone.Conclusions\n\nThis report provides a clinically usable, stepwise framework that integrates FMEP, DES, and free-running EMG thresholds for intraoperative prediction of facial nerve function.Significance\n\nDespite routine use of intraoperative neurophysiological monitoring, no standardized framework has existed to translate real-time signals into postoperative facial nerve predictions. This framework fills that gap by offering surgeons and monitoring teams a clear, evidence-based, and chronologically ordered decision aid, potentially improving early recognition of poor outcomes and facilitating timely referral for facial reanimation.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha 410008, China."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Juan Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Qing Liu"
    },
    {
      "affs": [
        0
      ],
      "name": "Xianrui Yuan"
    },
    {
      "affs": [
        0
      ],
      "name": "Jian Yuan"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/04arg0xm1bbn6.bib",
  "cited_by": 0,
  "doi": "10.1016/j.cnp.2026.09.006",
  "fulltext_url": "https://europepmc.org/articles/PMC13677331",
  "id": "04arg0xm1bbn6",
  "issns": [
    "2467-981X"
  ],
  "landing_url": "https://europepmc.org/article/MED/42898074",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Intraoperative Neuromonitoring and Anesthetic Effects"
    ]
  ],
  "openalex": "W7214744448",
  "pdf_url": "https://europepmc.org/articles/PMC13677331?pdf=render",
  "pmcid": "PMC13677331",
  "pmid": "42898074",
  "published": "2026-09-29",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/04arg0xm1bbn6.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:37Z",
      "native_id": "MED:42898074",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42898074"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Intraoperative Neuromonitoring and Anesthetic Effects",
      "subfield": "surgery"
    }
  ],
  "title": "A practical framework for interpreting intraoperative electrophysiological signals in acoustic neuroma surgery.",
  "title_text": "A practical framework for interpreting intraoperative electrophysiological signals in acoustic neuroma surgery.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:37Z",
  "url": "https://research.draconitic.com/paper/04arg0xm1bbn6",
  "venue": "Clinical neurophysiology practice",
  "versions": []
}