小脑角肿瘤中面神经电运动诱发电位的解剖和功能保留。

Surgical neurology international Pub Date : 2024-05-31 eCollection Date: 2024-01-01 DOI:10.25259/SNI_14_2024
Mohammad Mazhar Khan, Abinash Dutta, Deepak Rajappa, Dattatraya Mallik, Matias Baldoncini, Carlos Castillo Rangel, Bipin Chaurasia
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引用次数: 0

摘要

背景:在保护面神经(FN)功能的技术措施中,术中神经监测已成为强制性措施,并不断受到关注。因此,为了确定面神经运动诱发电位(FNMEPs)在预测小脑角(CPA)肿瘤手术后面神经长期运动功能方面的有效性,我们对病例进行了分析:方法:在37例接受CPA手术的患者中,通过位于C5-C6和C6-C5(C为脑中心线,与10-20脑电图电极位置一致)的开瓶器电极进行FNMEPs,以提供短列车刺激,并记录眼轮匝肌、口轮匝肌和心轮匝肌的电位:结果:在58例患者中,触发肌电图(EMG)能够在肿瘤切除过程中识别出FN,但其中8例(4.64%)患者出现了新的面部无力,而在38例FN功能MEP(FN目标肌肉的减弱--CMAPs振幅峰值到峰值>50-60%)完好的患者中,有3例(1.11%)出现了新的面部无力(House和Brackmann分级为II级到III级):结论:当肿瘤巨大并包绕 FN 时,FNMEP 比触发 EMG 有明显优势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Facial nerve electrical motor evoked potential in cerebellopontine angle tumors for its anatomical and functional preservation.

Background: Among the technical measures to preserve facial nerve (FN) function, intraoperative neuromonitoring has become mandatory and is constantly being scrutinized. Hence, to determine the efficacy of FN motor evoked potentials (FNMEPs) in predicting long-term motor FN function following cerebellopontine angle (CPA) tumor surgery, an analysis of cases was done.

Methods: In 37 patients who underwent CPA surgery, FNMEPs through corkscrew electrodes positioned at C5-C6 and C6-C5 (C is the central line of the brain as per 10-20 EEG electrode placement) were used to deliver short train stimuli and recorded from the orbicularis oculi, oris, and mentalis muscles.

Results: In 58 patients, triggered electromyography (EMG) was able to identify the FN during resection of tumor, but 8 out of these (4.64%) patients developed new facial weakness, whereas 3 out of 38 (1.11%) patients who had intact FN function MEP (decrement of FN target muscles - CMAPs amplitude peak to peak >50-60%), developed new facial weakness (House and Brackmann grade II to III).

Conclusion: The FNMEP has significant superiority over triggered EMG when tumor is giant and envelops the FN.

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