Automated intraoperative monitoring of facial nerve function

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Aim of the submitted knowledge transfer study is the implementation of a prototype for the automated detection of pathological A-train activity in the electromyographic activity of the facial muscles. Evaluation of these patterns enables the intraoperative detection of potential nerve damage and consequently avoiding postoperative facial palsy. The method has been developed in the preceding DFG-funded project. Implementation of the prototype will be conducted in collaboration with inomed GmbH as industry partner.In a first stage, a testing platform will be implemented, allowing testing and validation of the components and composite system developed during the project. Datasets of more than 100 patients are available, who underwent surgery for vestibular schwannoma in the previous project. The data contain A-train patterns in different quantities; pre- and postoperative degree of facial palsy was evaluated and documented in a consistent manner. On this basis, the detection method will be reimplemented and optimized. In parallel, data are recorded using the hardware, which will be utilized by the prototype. Analysis of this data and comparison with the test platform enables further hardware-specific adaptations of the procedure. A first prototype will then be implemented, which can be evaluated intraoperatively, simultaneous with routine recordings. Finally, the resulting prototype will be implemented in compliance with CE standards.Following the project, further development of the prototype into a fully certified medical device and market-ready product is planned. This will also enable a multi-center study on A-train monitoring during surgery in the cerebello-pontine angle.