Article Text

other Versions

PDF
Facial nerve motor evoked potential monitoring during skull base surgery predicts facial nerve outcome
  1. Masafumi Fukuda (mfuku529{at}bri.niigata-u.ac.jp)
  1. Department of Neurosurgery, Brain Research Institute, University of Niigata, Japan
    1. Makoto Oishi
    1. Department of Neurosurgery, Brain Research Institute, University of Niigata, Japan
      1. Tetsuro Takao
      1. Department of Neurosurgery, Brain Research Institute, University of Niigata, Japan
        1. Akihiko Saito
        1. Department of Neurosurgery, Brain Research Institute, University of Niigata, Japan
          1. Yukihiko Fujii
          1. Department of Neurosurgery, Brain Research Institute, University of Niigata, Japan

            Abstract

            Objective: To determine whether monitoring facial nerve motor evoked potentials (FNMEPs) elicited by transcranial electrical stimulation during skull base tumour surgery is useful for predicting facial nerve outcome.

            Methods: We analysed FNMEP findings in 26 patients with skull base tumour. Corkscrew electrodes positioned at C3 or C4 and Cz were used to deliver supramaximal stimuli (180-550 V). FNMEPs were recorded from the orbicularis oculi and oris muscles. Correlation between the final-to-baseline FNMEP ratio and postoperative facial nerve function was examined.

            Results: Postoperative facial nerve function correlated significantly with the FNMEP ratios in the orbicularis oculi (p = 0.004) and orbicularis oris (p < 0.001) muscles. An FNMEP ratio of < 50% consistently predicted immediate postoperative facial palsy, although the degree of palsy differed among patients. All patients had satisfactory facial nerve function (House & Brackmann grades I and II) postoperatively if the FNMEP ratio remained at > 50%.

            Conclusions: Intraoperative FNMEP monitoring can be useful for predicting facial nerve function after skull base surgery. This new method is a valuable adjunct to conventional facial nerve monitoring.

            • Facial nerve
            • Motor evoked potentials
            • Skull base tumour
            • Transcranial electrical stimulation
            • Vestibular schwannoma

            Statistics from Altmetric.com

            Request permissions

            If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.