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Evaluation of the prognostic value of multimodal intraoperative monitoring in posterior fossa surgery patients with cerebellopontine angle tumors

The aim of this study was to compare the outcomes of four intraoperative monitoring approaches in order to compare their prognostic value in surgical complications of the facial nerve. This quasi-experimental study was conducted on 25 patients with Cerebellopontine Angle (CPA) tumors, who were hospi...

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Autores principales: Dalvandi, Mohsen, Rafie, Ali Nazemi, Kamali, Alireza, Jamshidifard, Alireza
Formato: Online Artículo Texto
Lenguaje:English
Publicado: PAGEPress Publications, Pavia, Italy 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895985/
https://www.ncbi.nlm.nih.gov/pubmed/29686816
http://dx.doi.org/10.4081/ejtm.2018.7260
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author Dalvandi, Mohsen
Rafie, Ali Nazemi
Kamali, Alireza
Jamshidifard, Alireza
author_facet Dalvandi, Mohsen
Rafie, Ali Nazemi
Kamali, Alireza
Jamshidifard, Alireza
author_sort Dalvandi, Mohsen
collection PubMed
description The aim of this study was to compare the outcomes of four intraoperative monitoring approaches in order to compare their prognostic value in surgical complications of the facial nerve. This quasi-experimental study was conducted on 25 patients with Cerebellopontine Angle (CPA) tumors, who were hospitalized in the Valiasr Hospital, affiliated to the Arak University of Medical Sciences, Arak, Iran. The degree of the facial nerve paralysis was assessed based on the House-Brackmann (HB) facial nerve grading system. The Orbicularis oris and Oculi muscles were evaluated by electromyography (EMG) before and after the surgery. Monitoring the facial nerve was performed by the EMG, Facial Nerve Antidromic Potentials (FNAPs), Transcranial Electrical Stimulation (TES), and Brainstem Auditory Evoked Potentials (BAEPs) methods. The mean HB score was 0.36.6±5.83, indicating that the function of the facial muscle was abnormal in all the patients pre-surgery. The comparison of the four monitoring approaches six months after surgery showed that the predictive value of facial nerve TES was higher than the other approaches (P<0.005). Furthemroe, 4% of the patients showed normal function in the facial muscle after the surgery. In addition, 8%, 56%, and 32% of the patients had mild abnormalities, moderate to severe paralysis in the facial muscles, and severe facial nerve dysfunction, respectively. In summary, 36% of the patients showed a mild abnormalities in the follow-up period, and full recovery was observed in 28% of the cases. In conclusion, the transcranial motor evoked potential (TCMEP) is a useful method for monitoring the facial nerve during the surgery along with the continuous EMG recordings.
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spelling pubmed-58959852018-04-23 Evaluation of the prognostic value of multimodal intraoperative monitoring in posterior fossa surgery patients with cerebellopontine angle tumors Dalvandi, Mohsen Rafie, Ali Nazemi Kamali, Alireza Jamshidifard, Alireza Eur J Transl Myol Article The aim of this study was to compare the outcomes of four intraoperative monitoring approaches in order to compare their prognostic value in surgical complications of the facial nerve. This quasi-experimental study was conducted on 25 patients with Cerebellopontine Angle (CPA) tumors, who were hospitalized in the Valiasr Hospital, affiliated to the Arak University of Medical Sciences, Arak, Iran. The degree of the facial nerve paralysis was assessed based on the House-Brackmann (HB) facial nerve grading system. The Orbicularis oris and Oculi muscles were evaluated by electromyography (EMG) before and after the surgery. Monitoring the facial nerve was performed by the EMG, Facial Nerve Antidromic Potentials (FNAPs), Transcranial Electrical Stimulation (TES), and Brainstem Auditory Evoked Potentials (BAEPs) methods. The mean HB score was 0.36.6±5.83, indicating that the function of the facial muscle was abnormal in all the patients pre-surgery. The comparison of the four monitoring approaches six months after surgery showed that the predictive value of facial nerve TES was higher than the other approaches (P<0.005). Furthemroe, 4% of the patients showed normal function in the facial muscle after the surgery. In addition, 8%, 56%, and 32% of the patients had mild abnormalities, moderate to severe paralysis in the facial muscles, and severe facial nerve dysfunction, respectively. In summary, 36% of the patients showed a mild abnormalities in the follow-up period, and full recovery was observed in 28% of the cases. In conclusion, the transcranial motor evoked potential (TCMEP) is a useful method for monitoring the facial nerve during the surgery along with the continuous EMG recordings. PAGEPress Publications, Pavia, Italy 2018-02-16 /pmc/articles/PMC5895985/ /pubmed/29686816 http://dx.doi.org/10.4081/ejtm.2018.7260 Text en http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License (by-nc 4.0) which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
spellingShingle Article
Dalvandi, Mohsen
Rafie, Ali Nazemi
Kamali, Alireza
Jamshidifard, Alireza
Evaluation of the prognostic value of multimodal intraoperative monitoring in posterior fossa surgery patients with cerebellopontine angle tumors
title Evaluation of the prognostic value of multimodal intraoperative monitoring in posterior fossa surgery patients with cerebellopontine angle tumors
title_full Evaluation of the prognostic value of multimodal intraoperative monitoring in posterior fossa surgery patients with cerebellopontine angle tumors
title_fullStr Evaluation of the prognostic value of multimodal intraoperative monitoring in posterior fossa surgery patients with cerebellopontine angle tumors
title_full_unstemmed Evaluation of the prognostic value of multimodal intraoperative monitoring in posterior fossa surgery patients with cerebellopontine angle tumors
title_short Evaluation of the prognostic value of multimodal intraoperative monitoring in posterior fossa surgery patients with cerebellopontine angle tumors
title_sort evaluation of the prognostic value of multimodal intraoperative monitoring in posterior fossa surgery patients with cerebellopontine angle tumors
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895985/
https://www.ncbi.nlm.nih.gov/pubmed/29686816
http://dx.doi.org/10.4081/ejtm.2018.7260
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