连续监测诱发面神经肌电图检测面神经神经鞘瘤患者的神经减压时刻:1例报告。

NMC Case Report Journal Pub Date : 2022-07-19 eCollection Date: 2022-01-01 DOI:10.2176/jns-nmc.2022-0117
Asuka Nakazaki, Shigeru Yamaguchi, Hiroaki Motegi, Yukitomo Ishi, Michinari Okamoto, Miki Fujimura
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引用次数: 1

摘要

面神经神经鞘瘤(FNS)手术中面神经功能的改善是一个具有挑战性的目标。在听神经瘤手术中对诱发面神经肌电图(CFN-EMGs)进行术中连续监测,以保护面神经功能。应用cfn -肌电图对伴有严重面部瘫的FNS进行减压手术。一名39岁女性,表现为突发性眩晕、左侧听力障碍和严重左侧面瘫,伴有House-Brackmann (HB) 5级。根据患者的临床病程和磁共振成像表现,强烈怀疑为FNS,患者在发病9周后行内耳道手术减压(IAC)以改善面神经功能。在切除IAC后壁并切开其硬脑膜后,CFN-EMG反应突然改善。由于术后患者面神经麻痹改善到HB 2级,cfn - emg可以检测到面神经减压的瞬间。这将是首次报道cfn - emg应用于FNS减压手术可以实时检测术中减压效果。因此,CFN-EMGs可能是FNS减压手术中有效的监测方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Detection of the Moment of Nerve Decompression Using Continuous Monitoring of Evoked Facial Nerve Electromyograms in a Patient with Facial Nerve Schwannoma: Case Report.

Detection of the Moment of Nerve Decompression Using Continuous Monitoring of Evoked Facial Nerve Electromyograms in a Patient with Facial Nerve Schwannoma: Case Report.

Detection of the Moment of Nerve Decompression Using Continuous Monitoring of Evoked Facial Nerve Electromyograms in a Patient with Facial Nerve Schwannoma: Case Report.

Detection of the Moment of Nerve Decompression Using Continuous Monitoring of Evoked Facial Nerve Electromyograms in a Patient with Facial Nerve Schwannoma: Case Report.

Facial nerve function improvement is a challenging goal in facial nerve schwannoma (FNS) surgery. Intraoperative continuous monitoring of evoked facial nerve electromyograms (CFN-EMGs) is performed in acoustic neuroma surgery to preserve facial nerve function. CFN-EMGs were applied in decompression surgery for FNS with severe facial paresis. A 39-year-old woman presented with a sudden onset of vertigo, left hearing disturbance, and severe left facial palsy with House-Brackmann (HB) grade 5. FNS was strongly suspected based on the patient's clinical course and magnetic resonance imaging findings, and the patient underwent surgical decompression of the internal auditory canal (IAC) to improve facial nerve function 9 weeks after onset. CFN-EMG responses suddenly improved after removing the posterior wall of the IAC and incising its dura matter. Since the patient's facial nerve paresis improved to HB grade 2 after surgery, CFN-EMGs could detect the moment of facial nerve decompression. This would be the first report to show that CFN-EMGs applied in decompression surgery for FNS could detect the effects of decompression during surgery in real-time. Thus, CFN-EMGs may be an effective monitoring method in decompression surgery for FNS.

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