TcMEP threshold change is superior to A-train detection when predicting facial nerve outcome in CPA tumour surgery

Acta neurochirurgica
Tom HendriksMark Ter Laan

Abstract

Surgery of tumours in the cerebellopontine angle (CPA) can lead to loss of facial nerve function. Different methods of intra-operative nerve monitoring (IOM) (including free-running EMG, direct nerve stimulation and transcranial motor evoked potentials (TcMEP)) have been used to predict facial nerve outcome during surgery. Recent research has shown TcMEP threshold increase and the occurrence of A-trains on the EMG to have great potential in doing so. This study compares these two methods and correlates them to House-Brackmann (HB) scores post-op in patients with tumours in the cerebellopontine angle. Forty-three patients (one was operated twice) with large CPA tumours treated surgically in the Radboud University Medical Center between 2015 and 2019 were included in this study. During surgery, TcMEP threshold increases and A-train activity were measured. Because our treatment paradigm aims at facial nerve preservation (accepting residual tumour), TcMEP threshold increase of over 20 mA or occurrence of A-trains were considered as warning signs and used as a guide for terminating surgery. HB scores were measured post-op, at 6 weeks, 6 months and 1 year after surgery. Spearman's correlation was calculated between the IOM-values and...Continue Reading

References

May 28, 2009·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Willem P GodefroyMartijn J A Malessy
Jul 30, 2011·Clinical Neurology and Neurosurgery·Cordula MatthiesKarlheinz Reiners
Nov 29, 2011·World Neurosurgery·Joana SilvaRui Vaz
Sep 4, 2012·Neurosurgical Focus·Shaheryar F AnsariAaron A Cohen-Gadol
Aug 10, 2013·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Marc S SchwartzRick A Friedman
Sep 3, 2013·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Julian PrellStefan Rampp
Oct 2, 2013·Journal of Neurological Surgery. Part B, Skull Base·Maura K CosettiJ Thomas Roland
Jul 13, 2014·Neurosurgical Review·Hiroshi TokimuraKazunori Arita
Aug 16, 2016·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Sanjiv K BhimraoRyojo Akagami

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