Optic Nerve Monitoring

Abstract

Orbital and anterior skull base surgery is generally performed close to the prechiasmatic visual pathway, and clear strategies for detecting and handling visual pathway damage are essential. To overcome the common problem of a missed clinical examination because of an uncooperative or unresponsive patient, flash visual evoked potentials and electroretinograms should be used. These electrophysiologic examination techniques can provide evidence of intact, pathologic, or absent conductivity of the visual pathway when clinical assessment is not feasible. Visual evoked potentials and electroretinograms are thus essential diagnostic procedures not only for primary diagnosis but also for intraoperative evaluation. A decision for or against treatment of a visual pathway injury has to be made as fast as possible due to the enormous importance of the time elapsed with such injuries; this can be achieved additionally using multislice spiral computed tomography. The first-line conservative treatment of choice for such injuries is megadose methylprednisolone therapy. Surgery is used to decompress the orbital compartment by exposure of the intracanalicular part of the optic nerve in the case of optic canal compression. Modern craniomaxillofacial surgery requires detailed consideration of the diagnosis and treatment of traumatic visual pathway damage with the ultimate goal of preserving visual acuity.

An insight into the vision impairment following traumatic brain injury

“…More specifically, the optic nerve is damaged at the lamina crib rosa due to the rotation of the globe and results in an increase in intraocular pressure. This can be diagnosed by optical imaging and ultrasound imaging (Sawhney et al, 2003; Schumann et al, 2013; Ventura et al, 2014). …”

Totally Organic Hydrogel‐Based Self‐Closing Cuff Electrode for Vagus Nerve Stimulation

“…[1] For example, intraoperative neuromonitoring is important to protect normal organ functions from surgical damage. [2,3] Implanted DOI: 10.1002/adhm.202201627 stimulation electrodes are powerful method to support or restore functions of the central and peripheral nervous system (PNS), cardiovascular system, musculoskeletal system, and urogenitary system. [4][5][6][7][8] The vagus nerve (VN), which is the main component of the parasympathetic nervous system, [9] is an important target for implantable electrodes because vagus nerve stimulation (VNS) plays a crucial role in treating refractory epilepsy and chronic treatment resistant depression.…”