BACKGROUND. Intraoperative neural monitoring (IONM) has begun to be studied in detail by surgeons around the world since several decades ago from the need to verify functional integrity of the neural elements. Parotid gland surgery requires a thorough knowledge of the anatomy of this region by ENT surgeons. Also, the surgeons performing parotid surgery need to have important strategies of management which include: handiness to identify facial nerve, dissection nerve branches and application of neuromonitoring in order to preserve nerve functions. OBJECTIVE. This study has analysed the usefulness of intraoperative continuous monitoring in superficial or in total parotidectomy. It identifies the facial nerve and reduces the risk of postoperative facial palsy. We have been using intraoperative continuous monitoring - evoked facial nerve electromyograms (EMG). MATERIAL AND METHODS. Continuous intraoperative facial nerve monitoring was prospectively achieved in the case of three patients diagnosed with benign tumors, on which parotidectomy with the preservation of the nerve was carried out in order to highlight the value and efficacy of this method. RESULTS. In our country, continuous intraoperative facial nerve monitoring performance is still not a common practice in ENT Departments. It revealed postoperatively that the incidence of temporary or permanent facial palsy was 0% and the minimal stimulation was obtained at levels equal to 0,5 mA, which implies integral functioning of the facial nerve. CONCLUSION. In parotid surgery, facial nerve IONM represents the gold standard in recognition of real-time electrophysiological signals, electromyography waves and auditory signals to enable the correct approach wherever possible, avoiding extensive nerve damage. It is known the importance of continuous IONM in postoperative prognosis of the neural function and intraoperative decision making regarding the technical surgery.

In recent years, the clinical importance of laryngeal electromyography (LEMG) has been recognized. This method of investigation proved itself to be a valuable and indispensable tool regarding voice disorder management and requires multidisciplinary approach. In this article, we focus on the clinical usefulness of LEMG to assess inferior and superior motor neuron integrity by recording action potentials generated by muscle fibers of the larynx in the new field known as neurolaryngology. To facilitate the clinical application of this electrophysiologic test, we present a detailed description of LEMG techniques, which were applied for simultaneous bilateral recordings of the thyroarytenoid, cricothyroid and posterior cricoarytenoid muscles. Also, we analysed and measured the following electrophysiological parameters: 1) insertional activity; 2) spontaneous activity; 3) recruitment; 4) morphology of waveform. From a practical point of view, in our country, LEMG performance is still not a routine procedure in ENT and Phoniatric Departments. The difficulty of practical use of LEMG in Romania consists in technical limitations and it depends on the physician’s experience regarding the examination technique and also the interpretation of electrophysiological results. Our current clinical experience shows that the use of LEMG contributes especially to the diagnosis, prognosis and treatment of patients with neurolaryngological disorders.