Intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation for preservation of facial nerve function in patients with large acoustic neuroma

Liu, Baiyun; Yong-ji, Tian; Liu, Wen; Liu, Shu-Ling; Qiao, Hui; Zhang, Junting; Jia, Guijun

doi:10.1097/00029330-200702020-00013

Cited by 30 publications

(13 citation statements)

References 16 publications

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“…However, false positive monitoring results with a substantial amount of A-train activity, yet only slight or even no postoperative facial nerve deficit have been observed repeatedly (Prell et al, 2007(Prell et al, , 2010Rampp et al, 2012). Mainly because of these results, the positive predictive value of traintime-monitoring has been calculated to be no higher than 64% (Prell et al, 2014), which is still in the same range as the reported positive predictive value of, e.g., MEP-monitoring of the facial nerve, which has been shown to be 53-61% if technical failures are excluded (Dong et al, 2005;Fukuda et al, 2008;Liu et al, 2007;Matthies et al, 2011). Nevertheless, these false positive monitoring results do limit the clinical value of traintime-monitoring.…”

Section: Introductionmentioning

confidence: 90%

“…All contemporary means of facial nerve monitoring in vestibular schwannoma patients (like corticobulbar motor evoked potentials and direct electrical stimulation) are universally, at least to some degree, flawed by false positive monitoring results, which lead to positive predictive values of only 46-61% (Dong et al, 2005;Fukuda et al, 2008;Liu et al, 2007;Matthies et al, 2011;Schmitt et al, 2013). For quantitative monitoring of the free-running EMG by realtime-assessment of traintime, a positive predictive value of 64% (Prell et al, 2010) has been calculated, which is in the same unfavorable range.…”

Section: Split Nervementioning

confidence: 99%

“…While monitoring of corticobulbar potentials in terms of motor evoked potentials (MEP) has recently been added to the available techniques (Dong et al, 2005;Fukuda et al, 2008;Liu et al, 2007;Matthies et al, 2011), monitoring of free-running EMG will be used in most institutions at least as a complementary, if not the only monitoring technique regarding facial nerve function.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The intermedius nerve as a confounding variable for monitoring of the free-running electromyogram

Prell¹,

Strauß²,

Rachinger³

et al. 2015

Clinical Neurophysiology

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Section: Introductionmentioning

confidence: 90%

Section: Split Nervementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The intermedius nerve as a confounding variable for monitoring of the free-running electromyogram

Prell¹,

Strauß²,

Rachinger³

et al. 2015

Clinical Neurophysiology

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“…[16][17][18][19] Recently, transcranial stimulation techniques have been applied to intraoperative facial nerve monitoring with favorable results. [20][21][22][23][24][25][26] Studies indicate that TCMEP of the facial nerve is feasible and may predict immediate postoperative outcome. Long-term functional data and the relationship between TCMEP and facial nerve function beyond the immediate postoperative period is lacking.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Transcranial Motor-Evoked Potential Monitoring of the Facial Nerve during Cerebellopontine Angle Tumor Resection

Cosetti

Rivera

et al. 2012

J Neurol Surg B

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Objective?To determine whether transcranial motor-evoked potential (TCMEP) monitoring of the facial nerve (FN) during cerebellopontine angle (CPA) tumor resection can predict both immediate and long-term postoperative FN function. Design?Retrospective review. Setting?Tertiary referral center. Main Outcome Measures?DeltaTCMEP (final-initial) and immediate and long-term facial nerve function using House Brackmann (HB) rating scale. Results?Intraoperative TCMEP data and immediate and follow-up FN outcome are reported for 52 patients undergoing CPA tumor resection. Patients with unsatisfactory facial outcome (HB >2) at follow-up had an average deltaTCMEP of 57?V, whereas those with HB I or II had a mean deltaTCMEP of 0.04?V (t?=?-2.6, p??2) facial function in the immediate postoperative period. Conclusion?Intraoperative TCMEP of the facial nerve can be a valuable adjunct to conventional facial nerve electromyography during resection of tumors at the CPA. Intraoperative deltaTCMEP >57?V may be worrisome for long-term recovery of satisfactory facial nerve function.

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“…Among many electrophysiological monitoring methods for the facial nerve, transcranial motor evoked potential (MEP) for the facial nerve (facial MEP) has been recently recognized as a safe and valuable quantitative method for monitoring the inherent variability of facial nerve function. [1][2][3][4] It is difficult to measure MEP of the facial nerve compared with that of the extremities. Because the stimulation point of the skull is near the recording point of the face, high-frequency, multipulse transcranial stimulation will affect the facial electromyogram (EMG), which will cause difficulty in reading the MEP wave.…”

mentioning

confidence: 99%

Intraoperative Monitoring of Motor Evoked Potential for the Facial Nerve Using a Cranial Peg-Screw Electrode and a “Threshold-level” Stimulation Method

et al. 2010

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Transcranial motor evoked potential (MEP) for the facial nerve (facial MEP) has been recognized as a good method for quantitative monitoring of facial nerve function in skull base surgery. To improve the feasibility and safety of facial MEP monitoring, a peg-screw electrode and a "threshold-level" method were investigated. From 2007 to 2009, intraoperative facial MEP monitoring with the peg-screw electrode and threshold-level method was successfully achieved in 26 of 29 patients who underwent surgery for the posterior fossa extra-axial tumor. The relationship between the change in the facial MEP threshold level and the postoperative function of the facial nerve was analyzed in 23 patients who had no facial palsy preoperatively. There were no complications associated with facial MEP monitoring. Nine patients who had stable facial MEP threshold had no facial palsy. Fourteen patients who had worsened but measurable facial MEP threshold had mild palsy at discharge. Two of three patients who had severely worsened and unmeasurable facial MEP threshold had severe facial palsy. The change in the facial MEP was well correlated with the postoperative facial function. The peg-screw electrode and threshold-level method are good options for facial MEP monitoring.

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Intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation for preservation of facial nerve function in patients with large acoustic neuroma

Cited by 30 publications

References 16 publications

The intermedius nerve as a confounding variable for monitoring of the free-running electromyogram

The intermedius nerve as a confounding variable for monitoring of the free-running electromyogram

Intraoperative Transcranial Motor-Evoked Potential Monitoring of the Facial Nerve during Cerebellopontine Angle Tumor Resection

Intraoperative Monitoring of Motor Evoked Potential for the Facial Nerve Using a Cranial Peg-Screw Electrode and a “Threshold-level” Stimulation Method

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