In reference to Electromyographic facial nerve monitoring during parotidectomy for benign lesions does not improve the outcome of postoperative facial nerve function: a prospective two-center trial.

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Dear Editor:I agree with Grosheva et al.'s conclusion that elec-tromyographic (EMG) monitoring in parotid surgery does not influence postoperative facial paralysis and their opinion that continuous visual facial observation is still the standard procedure for parotid surgery.In the field of otologic surgery, EMG facial nerve monitoring has been used routinely for a long time. EMG monitoring of the facial or acoustic nerve, which was approved by the National Institutes of Health, can be significantly efficacious for the preservation of facial or acoustic nerve function during acoustic neuroma (AN) or cerebellopontine angle (CPA) tumor surgery. Once the internal auditory canal or CPA is opened, the facial or acoustic nerve is exposed and just adjacent to other nerves. Therefore, EMG monitoring can easily distinguish the facial or acoustic nerve from other nerves. AN or CPA tumor surgery is totally different from that of parotid surgery.