Intraoperative monitoring during surgery for hypoglossal schwannoma

Ishikawa, Mami; Kusaka, Gen; Takashima, Kouichi; Kamochi, Haruna; Shinoda, Souji

doi:10.1016/j.jocn.2009.09.040

Cited by 16 publications

(11 citation statements)

References 10 publications

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“…Independently from the nerve that is affected, surgical treatment consists of systematic exeresis of the lesions. This has been furthermore confirmed by the experience of the present authors and by case reports (2,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)30,31). In fact, all except one of the cases were treated surgically.…”

Section: Imaging and Diagnosissupporting

confidence: 86%

“…In almost all cases, there are varying degrees of paresis of the HyN, which appear as ipsilateral deviation, hemiatrophy and fasciculations of the tongue. These symptoms may be accompanied by hoarseness, intermittent-to-persistent headaches, dysarthria, slurred speech, swallowing difficulties and throat cramps (2,4,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). Whereas the effects on the specific functions of the nerve may be attributable to the local damage of the tumour on the nerve, these types of lesions, particularly when they increase in volume, may determine mass effects on surrounding or adjacent structures; for example, Mariniello et al (19) reported on the case of a patient who exhibited signs of cerebellar ataxia, right-sided hypotonia and increased intracranial pressure.…”

Section: Discussionmentioning

confidence: 99%

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Schwannoma of the hypoglossal nerve: Review of the literature based on an illustrative case

et al. 2017

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Abstract. Schwannomas are benign tumours that originate from the myelin sheath of peripheral nerves. They are characterised by a slow growth tendency. Benign schwannomas represent 35% of the head and neck district tumours. Hypoglossal schwannomas account for 5% of non-vestibular schwannomas, and malignant schwannomas occur very rarely. In the present case report, the case of a 49-year-old man who presented with paraesthesias in the left parotid and submandibular region, associated with sensation of foreign bodies and dysphagia for solids, is described. A clinical examination revealed the presence of an ovoid palpable mass in the lateral-cervical region of the neck. The patient subsequently underwent excisional surgery, and neuropathological evaluation of the specimen confirmed the diagnosis of benign schwannoma with Antoni areas A and B. Despite the rarity of schwannomas, this condition should be considered in differential diagnoses for masses localised in the neck, as in cases where they reach considerable sizes (>3 cm in diameter). Surgery therefore represents the first-choice treatment.

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Section: Imaging and Diagnosissupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Schwannoma of the hypoglossal nerve: Review of the literature based on an illustrative case

et al. 2017

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“…The HN threshold MAP characteristics parallel FN responses. The HN supramaximal CMAPs have been reported as a means of following HN integrity during excision of an HN Schwannoma and vertebral aneurysm clipping (Ishikawa et al, 2010a(Ishikawa et al, , 2010b. It must be recalled, however, that nonsurface recording cannot display a fully summated CMAP.…”

Section: Cranial Nerve Stimulationmentioning

confidence: 99%

Neurophysiologic Monitoring of the Spinal Accessory Nerve, Hypoglossal Nerve, and the Spinomedullary Region

Skinner¹

2011

Journal of Clinical Neurophysiology

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This review of hypoglossal nerve, spinal accessory nerve, and spinomedullary region intraoperative monitoring details pertinent central and extramedullary anatomy, an updated understanding of proper free-run EMG recording methods and recent developments in stimulation technique and instrumentation. Mapping and monitoring the floor of the fourth ventricle, especially the vagal/hypoglossal trigone region, are emphasized. Although cranial nerve transcranial electrical motor evoked potential recordings can afford appreciation of corticobulbar/corticospinal tract function and secure a more dependable measure of proximate extramedullary somatoefferents, the sometimes difficult implementation and the, as yet, unresolved alert criteria of these recordings demand critical appraisal. Nearby and intimately associated cardiochronotropic and barocontrol neural networks are described; their better understanding is recommended as an important adjunct to "routine" neural monitoring. Finally, an Illustrative case is presented to highlight the many strengths and weaknesses of "state of the art" lower cranial nerve/spinomedullary region monitoring.

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“…Among them, the TcMEP is the only the indirect real-time technique to monitor the nerve function without approaching to the nerves. And there are many reports about monitoring CN IX, CN X, and CN XI by TcMEP as seen in a literature review [ 1 2 3 4 5 6 7 8 9 10 ]. However, the techniques to monitor the function of CN XII are restricted in s-EMG and t-EMG, and the use of TcMEP of CN XII has been neglected until now.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Monitoring of Hypoglossal Nerve Using Hypoglossal Motor Evoked Potential in Infratentorial Tumor Surgery: A Report of Two Cases

Kim

Choi

et al. 2018

Ann Rehabil Med

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The hypoglossal nerve (CN XII) may be placed at risk during posterior fossa surgeries. The use of intraoperative monitoring (IOM), including the utilization of spontaneous and triggered electromyography (EMG), from tongue muscles innervated by CN XII has been used to reduce these risks. However, there were few reports regarding the intraoperative transcranial motor evoked potential (MEP) of hypoglossal nerve from the tongue muscles. For this reason, we report here two cases of intraoperative hypoglossal MEP monitoring in brain surgery as an indicator of hypoglossal deficits. Although the amplitude of the MEP was reduced in both patients, only in the case 1 whose MEP was disappeared demonstrated the neurological deficits of the hypoglossal nerve. Therefore, the disappearance of the hypoglossal MEP recorded from the tongue, could be considered a predictor of the postoperative hypoglossal nerve deficits.

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Intraoperative monitoring during surgery for hypoglossal schwannoma

Cited by 16 publications

References 10 publications

Schwannoma of the hypoglossal nerve: Review of the literature based on an illustrative case

Schwannoma of the hypoglossal nerve: Review of the literature based on an illustrative case

Neurophysiologic Monitoring of the Spinal Accessory Nerve, Hypoglossal Nerve, and the Spinomedullary Region

Intraoperative Monitoring of Hypoglossal Nerve Using Hypoglossal Motor Evoked Potential in Infratentorial Tumor Surgery: A Report of Two Cases

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