PMID: 11905020Mar 22, 2002Paper

Intraoperative monitoring of hearing function in the removal of cerebellopontine angle tumor: auditory brainstem response and cochlear nerve compound action potential

No shinkei geka. Neurological surgery
Iwao YamakamiNobuo Oka

Abstract

Intraoperative hearing monitoring may be the best approach for hearing preservation in the removal of cerebellopontine angle (CPA) tumors. We designed an intracranial electrode for a reliable and consistent recording of the cochlear nerve compound action potential (CNAP), and compared the efficiency of the CNAP and auditory brainstem response (ABR) while monitoring the CPA tumor removal. Simultaneous intraoperative monitoring of CNAP and ABR were performed in 7 patients with CPA tumors (5 acoustic neurinomas and 2 epidermoids) undergoing tumor removal aimed at hearing preservation. We designed an intracranial electrode for CNAP monitoring made of a fine malleable insulated wire with a tiny tuft of oxidized cellulose on the tip. Postoperatively, the hearing of 6 patients was preserved. Useful hearing was preserved in 5 of those. ABR recordings were unsatisfactory because of severe artifacts during the tumor removal. It was discernible only in 2 of the 7 patients. Postoperatively, useful hearing was preserved in the 2 patients with a discernible ABR during the tumor removal. Four of 5 patients with no discernible ABR during the tumor removal preserved hearing. Before the tumor removal, all patients showed a reproducible CNAP of a...Continue Reading

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