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We will evaluate the value of electromyography (EMG) from cranial nerve (CN) V during endoscopic endonasal surgery (EES). EES is a minimally invasive form of skull base surgery. To date, no studies have been conducted examining the technique and value of free-run electromyography (f-EMG) of CN V during skull base surgeries and/or EES.We examined 18 patients who had EMG monitoring of CN V during an EES. A total of 29 CN V nerves were monitored among all the patients. Of those 18 patients, some underwent additional CN monitoring.One patient (5%) had significant EMG activity in the muscles supplied by CN V during the EES and did not have any neurological deficits. Of the other CNs monitored, significant EMG activity was present in CN VII, CN IX, CN X, CN III, and CN VI in 14%, 12%, 21%, 19%, and 5% of all those nerves monitored, respectively. No patients developed postoperative neurological deficits.It is possible to reliably monitor CN V during EES. The value of f-EMG monitoring of the trigeminal nerve during EES seems limited. A larger study of CN V with triggered EMG and f-EMG would be beneficial to evaluating the value of CN V monitoring during EES. [ABSTRACT FROM AUTHOR]