Intraoperative Neurophysiological Monitoring During Trigeminal Schwannoma Surgery.

Autor:	Jahangiri FR; Neurophysiology, Axis Neuromonitoring, Richardson, USA.; Neurophysiology, Global Innervation, Dallas, USA.; Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, USA., Azam A; Neurophysiology, Axis Neuromonitoring, Richardson, USA., Asdi RA; Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, USA.; Neurophysiology, Axis Neuromonitoring, Richardson, USA., Ahmad I; Neuronavigation, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, SAU., Basha SI; Ear, Nose, and Throat Surgery, Sheikh Khalifa Medical City, Abu Dhabi, ARE.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2020 Sep 03; Vol. 12 (9), pp. e10218. Date of Electronic Publication: 2020 Sep 03.
DOI:	10.7759/cureus.10218
Abstrakt:	Surgical manipulation during skull base surgeries places various cranial nerves (CN) at risk, including the nerves innervating the extraocular muscles. It could be very challenging for the surgeon to identify these cranial nerves due to the distortion of the normal anatomy by the tumors. Despite the recent advancement in technology, surgeries involving the third, fourth, fifth, and sixth cranial nerves still carry a risk of temporary or permanent paralysis of the muscles supplied by these cranial nerves. Intraoperative Neurophysiological Monitoring (IONM) with spontaneous and triggered electromyography (EMG) can help in guiding the surgeon in locating the nerves and avoiding any injury to them during the resection. IONM for extraocular cranial nerves requires highly skilled personnel with knowledge of anatomy and expertise in the placement of the electrodes. Benign tumors of the nerve sheath that arise from the perineural Schwann cells are known as schwannomas. Various cranial nerves might be involved in schwannomas of the head and neck. Trigeminal schwannomas are rare tumors. In this report, we describe the setup and stimulation technique and parameters as well as the benefits of utilizing IONM during the aggressive resection of a trigeminal schwannoma. The main purpose of utilizing IONM during these high-risk surgical procedures is to minimize any intraoperative damage to the neural structures involved. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2020, Jahangiri et al.)
Databáze:	MEDLINE
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