The predictive value of intraoperative facial motor evoked potentials in cerebellopontine angle tumor surgery

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology Pub Date : 2024-08-06 DOI:10.1016/j.clinph.2024.07.021

Szu-Yen Pan , Robert N. Holdefer , Han-Lin Wu , Chi-Ruei Li , Lanjun Guo

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引用次数: 0

Abstract

Objective

Our aim is to explore the value of intraoperative facial motor evoked potentials (FMEP) for facial outcomes in cerebellopontine angle (CPA) tumor surgery to provide an evidence-based consensus standard for future clinical practice and prospective studies.

Methods

Electronic databases were searched from inception to June 2023. Study quality was assessed with the QUADAS-2 tool. Bivariate and random-effects models for meta-analysis and meta-regression generated summary receiver operating characteristic curves (ROC) and forest plots for estimates of sensitivity and specificity.

Results

We included 17 studies (1,206 participants). Sensitivity was lower in the immediate (IM) post-operative (0.76, 95% CI 0.65–0.84) compared to follow-up (FU) period (0.82, 95% CI 0.74–0.88) while specificity was similar in both groups (IM, 0.94, 95% CI 0.89–0.97; FU, 0.93, 95% CI 0.87–0.96). Data driven estimates improved FMEP performance but require confirmation from future studies. Amplitude cutoff criteria and studies that scored new deficits as worse than House-Brackmann (HB) grade 2 yielded best sensitivities.

Conclusions

FMEP demonstrated statistically significant accuracy for facial function monitoring. Implementation of FMEPs varied widely across studies.

Significance

Our study is the first systematic review with meta-analysis to demonstrate that intraoperative FMEP is valuable in CPA tumor surgery for facial outcomes. Meta-regression identified the methods that were most useful in the application of FMEPs.

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小脑角肿瘤手术中术中面部运动诱发电位的预测价值

目的我们的目的是探讨术中面部运动诱发电位（FMEP）对小脑脑角（CPA）肿瘤手术面部预后的价值，为未来的临床实践和前瞻性研究提供基于证据的共识标准。使用 QUADAS-2 工具评估研究质量。用于荟萃分析和荟萃回归的双变量和随机效应模型生成了接收器操作特征曲线（ROC）汇总表和森林图，用于估计灵敏度和特异性。与随访期（FU）（0.82，95% CI 0.74-0.88）相比，术后即刻（IM）的灵敏度较低（0.76，95% CI 0.65-0.84），而两组的特异性相似（IM，0.94，95% CI 0.89-0.97；FU，0.93，95% CI 0.87-0.96）。数据驱动的估计值提高了 FMEP 的性能，但还需要未来研究的证实。振幅截断标准和将新的功能障碍评定为差于 House-Brackmann (HB) 2 级的研究产生了最佳灵敏度。意义我们的研究是第一项通过荟萃分析证明术中 FMEP 对 CPA 肿瘤手术面部结果有价值的系统性综述。元回归确定了在应用 FMEPs 时最有用的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neurophysiology 医学-临床神经学

CiteScore

8.70

自引率

6.40%

发文量

932

审稿时长

59 days

期刊介绍： As of January 1999, The journal Electroencephalography and Clinical Neurophysiology, and its two sections Electromyography and Motor Control and Evoked Potentials have amalgamated to become this journal - Clinical Neurophysiology. Clinical Neurophysiology is the official journal of the International Federation of Clinical Neurophysiology, the Brazilian Society of Clinical Neurophysiology, the Czech Society of Clinical Neurophysiology, the Italian Clinical Neurophysiology Society and the International Society of Intraoperative Neurophysiology.The journal is dedicated to fostering research and disseminating information on all aspects of both normal and abnormal functioning of the nervous system. The key aim of the publication is to disseminate scholarly reports on the pathophysiology underlying diseases of the central and peripheral nervous system of human patients. Clinical trials that use neurophysiological measures to document change are encouraged, as are manuscripts reporting data on integrated neuroimaging of central nervous function including, but not limited to, functional MRI, MEG, EEG, PET and other neuroimaging modalities.