Intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation for preservation of facial nerve function in patients with large acoustic neuroma.
- Author:
Bai-yun LIU
1
;
Yong-ji TIAN
;
Wen LIU
;
Shu-ling LIU
;
Hui QIAO
;
Jun-ting ZHANG
;
Gui-jun JIA
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Aged; Electric Stimulation Therapy; Electromyography; Evoked Potentials, Motor; Facial Nerve; physiopathology; Female; Humans; Male; Middle Aged; Monitoring, Intraoperative; Neuroma, Acoustic; physiopathology
- From: Chinese Medical Journal 2007;120(4):323-325
- CountryChina
- Language:English
-
Abstract:
BACKGROUNDAlthough various monitoring techniques have been used routinely in the treatment of the lesions in the skull base, iatrogenic facial paresis or paralysis remains a significant clinical problem. The aim of this study was to investigate the effect of intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation on preservation of facial nerve function.
METHODFrom January to November 2005, 19 patients with large acoustic neuroma were treated using intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation (TCEMEP) for preservation of facial nerve function. The relationship between the decrease of MEP amplitude after tumor removal and the postoperative function of the facial nerve was analyzed.
RESULTSMEP amplitude decreased more than 75% in 11 patients, of which 6 presented significant facial paralysis (H-B grade 3), and 5 had mild facial paralysis (H-B grade 2). In the other 8 patients, whose MEP amplitude decreased less than 75%, 1 experienced significant facial paralysis, 5 had mild facial paralysis, and 2 were normal.
CONCLUSIONSIntraoperative TCEMEP can be used to predict postoperative function of the facial nerve. The decreased MEP amplitude above 75 % is an alarm point for possible severe facial paralysis.
