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Titolo:
Intra-operative electromyographic monitoring of the lower cranial motor nerves (LCN IX-XII) in skull base surgery
Autore:
Schlake, HP; Goldbrunner, RH; Milewski, C; Krauss, J; Trautner, H; Behr, R; Sorensen, N; Helms, J; Roosen, K;
Indirizzi:
Univ Wurzburg, Dept Neurosurg, Head Clin, D-97080 Wurzburg, Germany Univ Wurzburg Wurzburg Germany D-97080 d Clin, D-97080 Wurzburg, Germany Univ Wurzburg, Dept Otorhinolaryngol, Head Clin, D-97080 Wurzburg, GermanyUniv Wurzburg Wurzburg Germany D-97080 d Clin, D-97080 Wurzburg, Germany Univ Wurzburg, Dept Anesthesiol, Head Clin, D-97080 Wurzburg, Germany UnivWurzburg Wurzburg Germany D-97080 d Clin, D-97080 Wurzburg, Germany Univ Cologne, Dept Neurosurg, D-50931 Cologne, Germany Univ Cologne Cologne Germany D-50931 Neurosurg, D-50931 Cologne, Germany
Titolo Testata:
CLINICAL NEUROLOGY AND NEUROSURGERY
fascicolo: 2, volume: 103, anno: 2001,
pagine: 72 - 82
SICI:
0303-8467(200107)103:2<72:IEMOTL>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
RECURRENT LARYNGEAL NERVE; SCHWANNOMAS ACOUSTIC NEUROMAS; FACIAL-NERVE; INTRAOPERATIVE IDENTIFICATION; IMPROVED PRESERVATION; THYROID-SURGERY; STIMULATION; RESECTION; PREDICTORS; MANAGEMENT;
Keywords:
accessory nerve; glossopharyngeal nerve; hypoglossal nerve; intra-operative monitoring; neurophysiological monitoring; skull base tumors; vagal nerve;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
41
Recensione:
Indirizzi per estratti:
Indirizzo: Schlake, HP Univ Wurzburg, Dept Neurosurg, Head Clin, Josef Schneider Str 11, D-97080 Wurzburg, Germany Univ Wurzburg Josef Schneider Str 11 Wurzburg Germany D-97080
Citazione:
H.P. Schlake et al., "Intra-operative electromyographic monitoring of the lower cranial motor nerves (LCN IX-XII) in skull base surgery", CLIN NEUROL, 103(2), 2001, pp. 72-82

Abstract

The functional preservation of lower (motor) cranial nerves (LCN) is endangered during skull base surgery. Intra-operative EMG monitoring of the LCN IX-XII was investigated in 78 patients undergoing 80 operations on Various skull base tumors with regard to technical feasibility and clinical efficacy. Ongoing 'spontaneous muscle activity' (SMA) and 'compound muscle action potentials' (CMAP) following supramaximal bipolar stimulation were intra-operatively recorded applying needle electrodes into the soft palate (CN IX, n = 76), the vocal cord (CN X: n = 72), the trapezius muscle (CN XI: n = 18), and the tongue (CN XII: II = 71). From 24/22/8 cases with LCN IX/X/XII deficits (despite monitoring) only 5/6/4 remained unchanged (3-6 months postoperative). An irreversible plegia of the LCN IX/X/XII occurred in three (1/1/1) patients. In 7/6/1 patients postoperative (3-6 months) LCN IX/X/XII function was better than preoperatively. In all patients accessory nerve function remained unchanged. 'Pathological' SMA of the LCN IX/X/XII occurred in 12/16/8 cases, but in only 6/5/3 cases corresponded to postoperative LCN deficits. Corresponding 'pathological' SMA patterns were found in 18/17/5 out of 24/22/8 cases with postoperative LCN IX/X/XII dysfunction. Reproducible CMAP of LCN IX/X/XI/XII could be recorded in 59/56/11/32 patients. Approximate 'normal' values were calculated and compared to (very few) data so far given in the literature. Electromyographic monitoring proved to be a safe tool for the intra-operative identification and localization of the LCN contributing to their anatomical and functional preservation. The predictivevalue of standard neurophysiological parameters for functional outcome, however, is limited. (C) 2001 Elsevier Science B.V. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/07/20 alle ore 01:43:23