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Titolo:
Intraoperative electromyographic monitoring of extra-ocular motor nerves (Nn. III, VI) in skull base surgery
Autore:
Schlake, HP; Goldbrunner, R; Siebert, M; Behr, R; Roosen, K;
Indirizzi:
Univ Wurzburg, Head Clin, Dept Neurosurg, D-97070 Wurzburg, Germany Univ Wurzburg Wurzburg Germany D-97070 rosurg, D-97070 Wurzburg, Germany Univ Wurzburg, Head Clin, Dept Ophthalmol, D-97070 Wurzburg, Germany Univ Wurzburg Wurzburg Germany D-97070 halmol, D-97070 Wurzburg, Germany Univ Cologne, Dept Neurosurg, Cologne, Germany Univ Cologne Cologne Germany Cologne, Dept Neurosurg, Cologne, Germany
Titolo Testata:
ACTA NEUROCHIRURGICA
fascicolo: 3, volume: 143, anno: 2001,
pagine: 251 - 261
SICI:
0001-6268(2001)143:3<251:IEMOEM>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACOUSTIC NEUROMA RESECTION; FACIAL-NERVE; VESTIBULAR SCHWANNOMA; IMPROVED PRESERVATION; STIMULATION; AMPLITUDE; THRESHOLD;
Keywords:
abducens nerve; intraoperative monitoring; oculomotor nerve; trochlear nerve;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Schlake, HP Univ Wurzburg, Klin & Poliklin Neurochirurg, Josef Schneider Str 11, D-97080 Wurzburg, Germany Univ Wurzburg Josef Schneider Str 11 Wurzburg Germany D-97080
Citazione:
H.P. Schlake et al., "Intraoperative electromyographic monitoring of extra-ocular motor nerves (Nn. III, VI) in skull base surgery", ACT NEUROCH, 143(3), 2001, pp. 251-261

Abstract

Background. Extraocular motor nerves (Nn. III, IV, VI) are at risk of damage during skull base surgery. A new recording technique was employed in 18 patients suffering from various skull base tumours in order to extend intra-operative EMG monitoring to the extra-ocular muscles. Methods. Selective intra-operative EMG recordings were obtained from extra-ocular muscles by placement of single-shafted bipolar needle electrodes under the guidance of B-mode ultrasound to visualise the needle tip within the target muscle in the orbital cavity. Findings. Following bipolar electrical stimulation, the oculomotor nerve (N.III) was intra-operatively identified in 5 out of 7 cases, and the abducens nerve (N.VI) in 12 out of 18 cases. Postoperative (3-6 months) oculomotor nerve function remained unchanged in 5 and improved in 2 patients. No permanent deterioration was observed. Abducens nerve function deteriorated in two patients and improved in one case, but remained unchanged in 15 cases. No side effects occurred. There was neither any distinct relation of ocularmotor nerve function to the kind and extent of SMA ("spontaneous muscle activity") patterns, nor could such relationship be detected with concern to neurophysiological parameters (latencies, amplitudes) of electrically evoked CMAP ("compound muscle action potentials"). Interpretation. The EMG technique proposed proved to be mainly effective as a mapping tool for intra-operative localisation and identification of ocular motor nerves in skull base surgery. However, the predictive value of conventional neurophysiological parameters for clinical outcome, seems to be rather poor. Further studies on a larger number of patients are therefore required to develop new quantification techniques which enable an intra-operative prediction of ocular motor nerve deficits. Further efforts are also necessary to extend this technique to the trochlear nerve.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/09/20 alle ore 17:17:14