Can Continuous Intraoperative Facial Electromyography Predict Facial Nerve Function Following Cerebellopontine Angle Surgery?

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概要

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• Intraoperative cranial nerve monitoring has significantly improved the preservation of facial nerve function following surgery in the cerebellopontine angle(CPA). Facial electromyography(EMG)was performed in 60 patients during CPA surgery. Pairs of needle electrodes were placed subdermally in the orbicularis oris and orbicularis oculi muscles. The duration of facial EMG activity was noted. Facial EMG potentials occurring in response to mechanical or metabolic irritation of the corresponding nerve were made audible by a loudspeaker. Immediate(4-7 days after tumor excision)and late(6 months after surgery)facial nerve function was assessed on a modified House-Brackmann scale. Late facial nerve function was good(House-Brackmann 1-2)in 29 of 60 patients, fair(House-Brackmann 3-4)in 14, and poor(House-Brackmann 5-6)in 17. Postmanipulation facial EMG activity exceeding 5 minutes in 15 patients was associated with poor late function in five, fair function insix, and good function in four cases. Postmanipulation facial EMG activity of 2-5 minutes in 30 patients was associated with good late facial nerve function in 20, fair in eight, and poor in two. The loss of facial EMG activity observed in 10 patients was always followed by poor function. Facial nerve function was preserved postoperatively in all five patients in whom facial EMG activity lasted less than 2 minutes. Facial EMG is a sensitive method for identifying the facial nerve during surgery in the CPA. EMG bursts area very reliable indicator of intraoperative facial nerve manipulation, but the duration of these bursts do not necessarily correlate with short-or long-term facial nerve function despite the fact that burst duration reflects the severity of mechanical aggression to the facial nerve.

• 2000-10-15

著者

• Brock Mario

  Department Of Neurosurgery Benjamin Franklin Medical Center Free University Of Berlin

• Funk Thomas

  Department Of Neurosurgery University Hospital Benjamin Franklin Free University Of Berlin

• KOMBOS Theodoros

  Department of Neurosurgery, Benjamin Franklin Medical Center, Free University of Berlin

• SUESS Olaf

  Department of Neurosurgery, University Hospital Benjamin Franklin, Free University of Berlin

• KERN Bodo-Christian

  Department of Neurosurgery, University Hospital Benjamin Franklin, Free University of Berlin

• PIETILA Tertu

  Department of Neurosurgery, University Hospital Benjamin Franklin, Free University of Berlin

• Kombos Theodoros

  Department Of Neurosurgery Benjamin Franklin Medical Center Free University Of Berlin

• Kombos Theodoros

  Department Of Neurosurgery University Hospital Benjamin Franklin Free University Of Berlin

• Suess Olaf

  Department Of Neurosurgery University Hospital Benjamin Franklin Free University Of Berlin

• Kern Bodo-christian

  Department Of Neurosurgery University Hospital Benjamin Franklin Free University Of Berlin

• Pietila Tertu

  Department Of Neurosurgery University Hospital Benjamin Franklin Free University Of Berlin

関連論文

• Can Continuous Intraoperative Facial Electromyography Predict Facial Nerve Function Following Cerebellopontine Angle Surgery?
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