Currently, Intraoperative neurophysiological checking (IOM) is a fundamental part of numerous surgeries. The cost-adequacy analysis supports facial nerve monitoring in the mastoid and middle ear surgery. Imaginative strategies for cranial nerve monitoring using techniques, for example, intraoperative F wave and transcranial electric motor evoked potential estimation are being examined yet to be widely adopted in Otolaryngology. The last strategy is used in neurosurgery and vascular surgery to give the benefits of not depending on the disturbing upgrade of the nerve, yet rather prompting of the cerebral cortex. Their utilization may be constrained by the necessity for just intravenous anesthetic agents because of the suppression of the signal when inhalational agents are utilized.