Neurophysiological identification of cranial nerves during endoscopic endonasal surgery of skull base tumors: a pilot study technical report.

Related Articles

Neurophysiological identification of cranial nerves during endoscopic endonasal surgery of skull base tumors: a pilot study technical report.

World Neurosurg. 2016 Oct 27;:

Authors: Shkarubo AN, Ogurtsova AA, Moshchev DA, Lubnin AJ, Andreev DN, Koval KV, Chernov I

Abstract
INTRODUCTION: Intraoperative identification of cranial nerves is crucial for safe surgery of skull base tumors. Currently, there is only a small number of published papers describing the technique of t-EMG in endoscopic endonasal removal of such tumors.
OBJECTIVE: To assess the effectiveness of trigger electromyography in preventing intraoperative cranial nerve damage in endoscopic endonasal surgery of skull base tumors.
MATERIALS AND METHODS: Nine patients were operated on using the endoscopic endonasal approach within a one-year period. The tumors included large skull base chordomas and trigeminal neurinomas localized in the cavernous sinus. During the surgical process, cranial nerve identification was carried out using monopolar and bipolar t-EMG methods. Assessment of cranial nerve functional activity was conducted both before and after tumor removal.
RESULTS: 17 nerves were mapped in 9 patients. Third, fifth, and sixth cranial nerves were identified intraoperatively. There were no cases of postoperative functional impairment of the mapped cranial nerves. In one case we were unable to get an intraoperative response from the fourth cranial nerve and observed its postoperative transient plegia (the function was normal before surgery).
CONCLUSION: Trigger electromyography allows to control the safety of the cranial nerves both during and after skull base tumor removal.

PMID: 27989971 [PubMed - as supplied by publisher]

http://ift.tt/2hN820j