术中神经电生理监测在颅底外科中的应用进展

临床颅底外科手术中充满各种风险,特别是有对神经系统结构造成损伤的潜在风险。有些损伤无法通过直接观察来判断,因此术中电生理监测(intraoperative neuroelectrophysiological monitoring,IONM)是神经外科手术医生术中实时监测和评估神经功能的重要手段。国外上世纪80年代就将其应用于颅底肿瘤手术中,但直至目前我国相关应用仍未普及。术中神经电生理监测是运用各种电生理技术,实时监测术中处于有损伤风险的神经系统功能的完整性,并提示手术医生及时终止风险性操作,有针对性的采取有效干预措施消除或减小神经损伤、改善患者预后的一门技术。近年来,颅底外科进展迅速,并向多学科协作和减少创伤的方向发展,术中神经电生理监测已经迅速发展为降低颅底手术中神经损伤发生率的重要辅助手段。

Intraoperative Neurophysiological Monitoring Progress in Skull Base Surgery

Clinical skull base surgery is full of risks, especially with structural damage to the nervous system of the potential risks. Some damage can not be judged by direct observation, so intraoperative electrophysiological monitoring (intraoperative neuroelectrophysiological monitoring, IONM) is a neurological surgeons intraoperative real-time monitoring and evaluation important means of nerve function. Abroad in the 1980s will be applied to the skull base tumor surgery, but until now has not yet spread of related applications. Intraoperative neurophysiological monitoring has been utilized in attempts to minimize neurological morbidity from operative manipulations. The goal of such monitoring is to identify changes in brain, spinal cord, and peripheral nerve function prior to irreversible damage. In recent years, the rapid progress of skull base surgery, to the multi-disciplinary collaboration and reduce trauma direction, intraoperative neurophysiological monitoring has quickly developed into an important adjunct to reduce the incidence of skull base surgery nerve injury.