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Intraoperative Cranial Nerve Monitoring In Otolaryngology-Head and Neck Surgery

Intraoperative Cranial Nerve Monitoring In Otolaryngology-Head and Neck Surgery

Otolaryngologists have been trained to perform, interpret, and utilize strategically intraoperative cranial nerve monitoring and nerve stimulation testing, which are surgically applicable to cranial nerves of the head and neck and can serve as effective adjuncts to anatomic knowledge and surgical technique.

Revised 01/2018
Adopted 03/11/2018


  1. Position Statement: Intraoperative Nerve Monitoring in Otologic Surgery. American. Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS/F). 2017 March;
  2. Wilson L, Lin E, Lalwani A. Cost-effectiveness of intraoperative facial nerve monitoring in middle ear or mastoid surgery. The Laryngoscope. 2003:113(10):1736-1745.
  3. Randolph GW, Dralle H and the International Neural Monitoring Study Group. Electrophysiologic recurrent laryngeal and nerve monitoring during thyroid and parathyroid surgery: International standards guidelines statement. Laryngoscope 2011; 121:S1-S16.
  4. Al-Qurayshi Z, Kandil E, Randolph GW. Cost-effectiveness of intraoperative nerve monitoring in avoidance of bilateral recurrent laryngeal nerve injury in patients undergoing total thyroidectomy. Br J Surg. 2017 Oct;104(11):1523-1531.
  5. Savvas E, Hillmann S, Weiss D, Koopmann M, Rudack C, Alberty J. Association Between Facial Nerve Monitoring With Postoperative Facial Paralysis in Parotidectomy. JAMA Otolaryngol Head Neck Surg. 2016 Sep 1;142(9):828-33. dLanišnik B, Žitnik L, Levart P, Žargi M, Rodi Z. The impact on post-operative shoulder function of intraoperative nerve monitoring of cranial nerve XI during modified radical neck dissection. Eur Arch Otorhinolaryngol. 2016 Dec;273(12):4445-4451.
  6. Heiser C, Hofauer B, Lozier L, Woodson BT, Stark T. Nerve monitoring-guided selective hypoglossal nerve stimulation in obstructive sleep apnea patients. Laryngoscope. 2016 Dec;126(12):2852-2858.

Important Disclaimer Notice (Updated 7/31/14)

Position Statements are approved by the American Academy of Otolaryngology—Head and Neck Surgery or Foundation (AAO-HNS/F) Boards of Directors and are typically generated from AAO-HNS/F committees. Once approved by the Academy or Foundation Board of Directors, they become official Position Statements and are added to the existing Position Statement library. In no sense do they represent a standard of care. The applicability of Position Statements, as guidance for a procedure, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. Adherence to these clinical Position Statements will not ensure successful treatment in every situation. As with all AAO-HNS/F guidance, this Position Statement should not be deemed inclusive of all proper treatment decisions or methods of care, nor exclusive of other treatment decisions or methods of care reasonably directed to obtaining the same results. Position Statements are not intended to and should not be treated as legal, medical, or business advice.

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