BACKGROUND: Although 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. METHOD: From 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. RESULTS: MEP 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. CONCLUSIONS: Intraoperative 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.
BACKGROUND: Although 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. METHOD: From 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. RESULTS: MEP 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. CONCLUSIONS: Intraoperative 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.
Authors: Maura K Cosetti; Ming Xu; Andrew Rivera; Daniel Jethanamest; Maggie A Kuhn; Aleksandar Beric; John G Golfinos; J Thomas Roland Journal: J Neurol Surg B Skull Base Date: 2012-10
Authors: Daniele Starnoni; Lorenzo Giammattei; Giulia Cossu; Michael J Link; Pierre-Hugues Roche; Ari G Chacko; Kenji Ohata; Majid Samii; Ashish Suri; Michael Bruneau; Jan F Cornelius; Luigi Cavallo; Torstein R Meling; Sebastien Froelich; Marcos Tatagiba; Albert Sufianov; Dimitrios Paraskevopoulos; Idoya Zazpe; Moncef Berhouma; Emmanuel Jouanneau; Jeroen B Verheul; Constantin Tuleasca; Mercy George; Marc Levivier; Mahmoud Messerer; Roy Thomas Daniel Journal: Acta Neurochir (Wien) Date: 2020-07-29 Impact factor: 2.216