Application of neurophysiological monitoring and microsurgical technique in acoustic neurinoma resection
10.3760/cma.j.issn.1001-2036.2010.01.011
- VernacularTitle:神经电生理监测技术和显微外科技术在听神经瘤手术中应用
- Author:
Chaoshi NIU
;
Shiying LING
;
Ying JI
;
Wanhai DING
;
Xiaofeng JIANG
;
Huilin LIU
;
Haining CHEN
;
Xiangpin WEI
;
Xianming FU
- Publication Type:Journal Article
- Keywords:
Acoustic ncurinoma;
Nerve EMG;
BAEP;
Facial nerve;
Microsurgery
- From:
Chinese Journal of Microsurgery
2010;33(1):23-26
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the application of neurophysiological monitoring and microsurgi-eal technique in acoustic neurinoma resection, exploring the significance of neurophysiological monitoring in facial and auditory nerve reservation of acoustic neuronma microsurgery. Methods Accompanied with EMG and BAEP nerve monitoring, 113 patients harboring acoustic neuroma were treated surgically by the subocipi-tal retrosigmoid approach for reserving facial and auditory nerve. The facial nerve was stimulated to evaluate its function during late-operation. Postoperative facial and auditory nerve function were valuated in all the postop-erative following up. Results All of them were treated microsurgically via the suboccipitai retrosigmoid ap-proach. Total tumors resection was achieved in 102 cases (90.3%), subtotal resection in 6 cases(5.3%) and partial resection in 5 case (4.4%). The facial nerve was preserved anatomically in 98 cases (86.7%), the functional valuation of facial nerve according to the House-Brakman (H-B) postoperatively: 86 cases (76.1%) in class Ⅰ -Ⅱ , 12 cases(lO.6%) in class Ⅲ-Ⅳ and 15 cases (13.3%) in class Ⅴ-Ⅵ. The acoustic nerve was preserved anatomically in 40 cases (35.4%). It denoted the good function of facial nerve responsing sensi-tively to electrostimulation ≤ 4mA at the end of operation. Conclusion Assisted with the intraoperative electrophysiological monitoring techniques, it would be greatly facilitate the preservation of facial and auditory nerve in acoustic neuroma resection. Simultaneously, it would valuate the functional convalescence by late-op-erative electrostimulation in the postoperation.
