- Patient is positioned supine with three safety straps (across the chest, hips, and legs) and test-roll performed to ensure that the table can be tilted safely intraoperatively
- Facial nerve integrity monitoring system (NIMS) electrodes are placed bilaterally. The electrode wires may be directed cephalad or caudad, but the path of the wires should not obscure visual monitoring of facial movement. It is helpful to separate the electrodes into left and right groups so they are oriented for plugging into the NIMS machine after draping
- Standard prep with povidone iodine
- Place a sterile towel under the head while an assistant lifts the head. Another assistant may be needed to hold the electrodes up.
- With the head still lifted and the scrub nurse helping to hold the sticky drape (Large Incise Drape) taut, center and slide the sticky drape under the head
- Fold the sticky drape in half ("clamshell")
- Trim the excess so the face is visible
- Plug the NIMS electrodes into the electrode box
- Place sterile towels and split sheet drapes from above and below. The drapes should allow the head to be turned intraoperatively.
- Cut the sticky drapes post-auricularly to expose the skin and place the irrigation pouches bilaterally. Staple in place.