Abstract
<jats:p>Relevance. Neuromonitoring plays an increasingly important role in modern maxillofacial surgery. The use of modern neuromonitoring methods significantly improves the quality and safety of surgical interventions, reduces the risk of neurological complications, and enhances the functional outcomes of treatment. Despite some limitations, the widespread implementation of neuromonitoring in maxillofacial surgery is crucial for the further development of this field. The aim of the study: based on the analysis of the current regulatory framework and literature sources, to substantiate the expediency of introducing neuromonitoring into the standard equipment of maxillofacial surgery departments, in particular, during surgical interventions associated with a high risk of damage to nerve structures. Materials and methods. Planned and conducted a statistical analysis of regulatory documents, as well as literature sources in databases eLIBRARY.ru, CyberLeninka, Pubmed. Results and discussion. The increase in the incidence of malignant neoplasms of the maxillofacial region, particularly tumors of the major salivary glands (mainly the parotid glands), highlights the need for improved surgical treatment methods. The key challenge of such surgeries is the high risk of intraoperative damage to the facial nerve, which can lead to paresis or paralysis requiring longterm rehabilitation. To optimize the intervention at the stage of preoperative planning, MRI with contrast enhancement is used, which allows to objectify the borders of the neoplasm, and for the verification of the diagnosis, a fine-needle aspiration biopsy is used. However, radiological diagnostics does not provide reliable visualization of the extratemporal part of the facial nerve, which increases the importance of intraoperative techniques. The use of neuromonitoring, as studies show (Pakhomova N. V., Kalakutsky N. V., et al.), allows to perform precise interventions with preservation of nerve structures even in extirpation. Statistics show that the frequency of nerve damage varies from 0.2% to 10%, and temporary nerve dysfunction is observed in 14–65% of patients after surgery. In developed countries, neuromonitoring is integrated into the standards of equipment for maxillofacial surgery departments, while in countries with developing economies, its use is limited by the high cost of equipment and the need for specialized staff training. The implementation of neuromonitoring is economically justified, as it reduces the number of complications, shortens hospital stays, and accelerates rehabilitation. In Russia, the lack of neuromonitoring in the current equipment standards (Order No. 422n of the Russian Ministry of Health dated June 14, 2019) hinders its widespread use, which requires changes to the regulatory framework. To fully realize the potential of this method, it is also necessary to develop training programs for medical personnel on how to use neuromonitoring systems. Conclusions. The introduction of the neuromonitoring system into the standard equipment of maxillofacial surgery departments will significantly reduce the risk of postoperative complications during surgeries with potential damage to nerve fibers, which often lead to disability of patients and prolong the rehabilitation period. The use of this technology improves the quality of surgical interventions by providing more accurate visualization of nerve structures, reduces the duration of surgery and the frequency of complications, which collectively improves the quality of medical care. However, the absence of neuromonitoring in the current standard equipment limits the ability of medical organizations to acquire it. In this regard, it is necessary to update the regulatory requirements for the equipment of maxillofacial surgery departments by including a neuromonitoring system. Promising areas of development include the development of improved neuromonitoring methods and the optimization of existing approaches to improve.</jats:p>