Intraoperative monitoring of the abducens nerve in extended endonasal endoscopic approach: A pilot study technical report期刊界 All Journals 搜尽天下杂志传播学术成果专业期刊搜索期刊信息化学术搜索

Intraoperative monitoring of the abducens nerve in extended endonasal endoscopic approach: A pilot study technical report

Affiliation:	1. Neurophysiology Department, National Institute of Neurology and Neurosurgery, Mexico City, Mexico;2. Neurosurgery Department, National Institute of Neurology and Neurosurgery, Mexico City, Mexico;3. Neuro-otology Department, National Institute of Neurology and Neurosurgery, Mexico City, Mexico;4. Neuro-ophthalmology Service, National Institute of Neurology and Neurosurgery, Mexico City, Mexico;5. Comprehensive Epilepsy Center of Long Island, St. Charles Hospital, Port Jefferson, NY, USA;6. Facultad de Medicina Mexicali, Universidad Autónoma de Baja California, Mexico;1. Occupational Health and Safety Research Institute Robert-Sauvé, 505 boul. De Maisonneuve Ouest, Montreal, Quebec H3A 3C2, Canada;2. Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal Rehabilitation Institute, Montreal, Canada;3. Department of Kinanthropology, University of Sherbrooke, 2500 Boul. Université, Sherbrooke, Quebec J1K 2R1, Canada;1. Unit of Neurosurgical Oncology, Department of Hematology and Hemato–Oncology Università degli Studi di Milano, Via Manzoni 56, 20089 Rozzano (MI), Italy;2. Neurosurgical Oncology, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089 Rozzano (MI), Italy;3. Department of Neurosurgery, Rush University Medical Center, 600 S Paulina Street, Chicago, IL 60612, USA;4. Laboratory of Motor Control, Department of Medical Biotechnologies and Translational Medicine, Università degli Studi di Milano, Humanitas Research Hospital, IRCCS, Milano 20089, Italy;1. Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;2. Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Abstract:	BackgroundTo determine the reliability and usefulness of intraoperative monitoring of the abducens nerve during extended endonasal endoscopic skull base tumor resection.MethodsWe performed abducens nerve intraoperative monitoring in 8 patients with giant clival lesions recording with needle electrodes sutured directly into the lateral rectus muscles of the eye to evaluate spontaneous electromyographic activity and triggered responses following stimulation of the abducens nerves.ResultsA total of 16 abducens nerves were successfully recorded during endoscopic endonasal skull base surgeries. Neurotonic discharges were seen in two patients (12% [2/16] abducens nerves). Compound muscle action potentials of the abducens nerves were evoked with 0.1–4 mA and maintained without changes during the neurosurgical procedures. No patient had new neurological deficits or ophthalmological complications post-surgery.ConclusionsIntraoperative monitoring of the abducens nerve during the extended endonasal endoscopic approach to skull base tumors appears to be a safe method with the potential to prevent neural injury through the evaluation of neurotonic discharges and triggered responses.

Keywords:	Abducens nerve Intraoperative monitoring Skull base surgery
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