The medium and long-term effect of electrophysiologic monitoring on the facial nerve function in minimally invasive surgery treating acoustic neuroma

Hou, Baohui

doi:10.3892/etm.2018.5683

Cited by 5 publications

(5 citation statements)

References 16 publications

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“…This study showed that the proximal stimulation threshold, proximal-to-distal amplitude ratio, and proximal amplitude could, to some extent, predict facial nerve functioning within seven days after acoustic neuroma resection. All three indicators were similar to those reported previously (11,13). This study's sensitivity and specificity results indicated that the proximal-to-distal amplitude ratio was the best predictor of facial nerve functioning.…”

Section: Discussionsupporting

confidence: 88%

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Electrophysiological mapping and assessment of facial nerve functioning during acoustic neuroma operations

Li¹,

Bao²,

Liang³

et al. 2021

Ann Transl Med

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Background: Electrophysiological monitoring is used routinely to protect the facial nerve during acoustic neuroma surgery. This study aimed to clarify the relationship between the facial nerve's electrophysiological monitoring parameters and its function after surgery.Methods: Fifty-two patients with acoustic neuroma who underwent surgery were included. After localizing the facial nerve, its monitoring results during surgeries performed at our center were analyzed. Postoperative nerve functioning was correlated with the stimulation threshold of the facial nerve's proximal segment, proximal-to-distal amplitude ratio of the facial nerve, and proximal stimulation amplitude. Receiveroperating characteristic curves of the three parameters were calculated.Results: Electrical stimulation accurately described the facial nerve's anatomic distribution after the depth of anesthesia was assessed via accessory nerve stimulation. The data recorded after resection showed that a higher proximal-to-distal amplitude ratio was associated with better facial nerve functioning (P=0.037). A lower stimulation threshold of the proximal segment correlated with better facial nerve functioning (P=0.038). Conclusions:The most sensitive index to predict postoperative nerve functioning is the facial nerve's proximal-to-distal amplitude ratio. Accessory nerve stimulation can determine the appropriate depth of anesthesia, Electromyography (EMG) monitoring of the facial nerve during acoustic neuroma surgery can protect it effectively.

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Section: Discussionsupporting

confidence: 88%

“…Several electrophysiological technology reports have predicted the facial nerve's postoperative functioning (11). However, few have detailed the procedures used to locate the nerve accurately.…”

Section: Introductionmentioning

confidence: 99%

Electrophysiological mapping and assessment of facial nerve functioning during acoustic neuroma operations

Li¹,

Bao²,

Liang³

et al. 2021

Ann Transl Med

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“…Moderate adhesions may damage the nerve, and severe adhesions may lead to separation of nerve fibers [ 16 ]. Although Hou [ 18 ] believed that small acoustic neuromas rarely infiltrate the facial nerve, this conclusion could not be applied to all patients. At present, it is believed that the adhesion degree of small tumor and facial nerve can also directly affect the surgical effect [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Analysis of Related Factors Affecting Facial Nerve Function after Acoustic Neuroma Surgery

Liu

Shen

Han

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To investigate the factors affecting facial nerve function after acoustic neuroma surgery and to provide theoretical reference for clinicians to preserve facial nerve function better after surgery. Methods. A retrospective cohort study was conducted to analyze the correlation between postoperative facial nerve function and surgical approach, age, sex, tumor size and adhesion degree of facial nerve in 152 patients with acoustic neuroma. Results. In the choice of surgical approach, there was no significant difference in the anatomy of the complete facial nerve in labyrinth path, retrosigmoid sinus path, and middle cranial fossa path. There was no statistically significant difference between the middle cranial fossa path and the retrosigmoid sinus path in facial nerve function preservation 7 days after surgery. The difference between middle cranial fossa path and labyrinthine path was statistically significant ( P < 0.01 ). There were statistically significant differences between labyrinth path and retrosigmoid sinus path ( P < 0.05 ). Logistic multivariate regression analysis showed that the operative approach and the degree of adhesion between tumor and facial nerve were the risk factors affecting functional preservation of facial nerve 7 days after surgery. Age and the degree of adhesion between tumor and facial nerve were the risk factors for functional preservation of facial nerve 1 year after operation. Conclusion. The facial nerve function injury in patients with acoustic neuroma may be related to the choice of surgical approach, the adhesion degree of tumor and facial nerve, and their age. Clinicians need to comprehensively evaluate the risk factors before surgery, so as to achieve individualized treatment to protect the integrity of postoperative facial nerve function of patients.

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“…In this case, it was important to identify the left RLN and to perform esophagectomy without nerve damage, and we decided to use intraoperative RLN monitoring. Intraoperative nerve monitoring is commonly performed in the field of otolaryngologic and head and neck surgery, and numerous reports of its beneficial effect in preventing RLN palsy have been published [12,13]. In this case, it was particularly difficult to grasp the anatomy around the DA, but the position of the left RLN could be easily confirmed by the magnified views offered by the thoracoscopic approach and RLN monitoring, and esophagectomy was successfully performed without nerve damage.…”

Section: Discussionmentioning

confidence: 88%

Thoracoscopic esophagectomy with left recurrent laryngeal nerve monitoring for thoracic esophageal cancer in a patient with a right aortic arch: a case report

et al. 2020

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Background: Surgery for cases of thoracic esophageal cancer with a right aortic arch is rare, and the anatomic abnormalities in such patients necessitate a different surgical approach. Since the position of the recurrent laryngeal nerve often differs from the usual in these cases, the lymph node dissection around the recurrent laryngeal nerve, which is an important step in surgery for thoracic esophageal cancer, requires careful attention. There are some reports on the usefulness of intraoperative recurrent laryngeal nerve monitoring during esophageal cancer surgery. Herein, we report a case of successful thoracoscopic esophagectomy for esophageal cancer in a patient with a right aortic arch using intraoperative recurrent laryngeal nerve monitoring. Case presentation: A 70-year-old man was diagnosed as having esophageal cancer (Ut, type 0-IIc, T1b/MtLt, type 0-IIc, T1b, N2, M0, cStage II) and was treated by neoadjuvant chemoradiotherapy followed by radical surgery. Preoperative CT examination revealed a right aortic arch, and based on the findings of 3D-CT, we classified the right aortic arch as type IIIB1 (Edwards classification), which is the most frequent type of right aortic arch. We performed thoracoscopic esophagectomy via a left thoracic approach with the patient placed in the prone position, cervical esophagogastric conduit reconstruction via the retrosternal route, and three-field lymph node dissection. Although Kommerell's diverticulum could be easily confirmed, the descending aorta took a meandering course, making it difficult for the esophagus to be mobilized and detached and therefore also to identify the ductus arteriosus and left recurrent laryngeal nerve. Intraoperative recurrent laryngeal nerve monitoring using NIM-RESPONSE® 3.0 (Medtronic Japan, Tokyo, Japan) allowed the position of the left recurrent laryngeal nerve to be accurately determined, and upper mediastinal lymph node dissection and mobilization of the upper thoracic esophagus were performed safely. Postoperatively, the patient showed no evidence of recurrent laryngeal nerve palsy, but needed conservative treatment for anastomotic leakage. The patient was discharged 46 days after the surgery.(Continued on next page)

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The medium and long-term effect of electrophysiologic monitoring on the facial nerve function in minimally invasive surgery treating acoustic neuroma

Cited by 5 publications

References 16 publications

Electrophysiological mapping and assessment of facial nerve functioning during acoustic neuroma operations

Electrophysiological mapping and assessment of facial nerve functioning during acoustic neuroma operations

Analysis of Related Factors Affecting Facial Nerve Function after Acoustic Neuroma Surgery

Thoracoscopic esophagectomy with left recurrent laryngeal nerve monitoring for thoracic esophageal cancer in a patient with a right aortic arch: a case report

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