Resection of Oculomotor Nerve Lesions Using Continuous Stimulation of the Oculomotor Nerve Proximal to the Lesion: A Technical Report
| Autor: | Ryosuke Matsuno, Haruka Kawano, Masahiro Nonaka, Junichi Takeda, Akio Asai, Haruna Isozaki, Takamasa Kamei, Takeshi Itakura, Taichi Omachi |
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| Rok vydání: | 2021 |
| Předmět: |
genetic structures
Intraoperative Neurophysiological Monitoring Biopsy Hamartoma Action Potentials Stimulation Lesion 03 medical and health sciences 0302 clinical medicine Tolosa-Hunt Syndrome medicine Oculomotor Nerve Diseases Humans Oculomotor nerve palsy Palsy medicine.diagnostic_test Oculomotor nerve business.industry Magnetic resonance imaging Anatomy medicine.disease Electric Stimulation Oculomotor Muscles 030220 oncology & carcinogenesis Child Preschool Surgery Female Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery Intraoperative neurophysiological monitoring |
| Zdroj: | World neurosurgery. 152 |
| ISSN: | 1878-8769 |
| Popis: | Background We describe a continuous monitoring method aimed at preserving nerve function during biopsy of lesions on the oculomotor nerve using stimulation of the oculomotor nerve proximal to the lesion. Case Description A 5-year-old girl with a recurrent left oculomotor nerve palsy and contrast-enhancing left oculomotor nerve mass on magnetic resonance imaging underwent a biopsy of the lesion to aid in its diagnosis. At the time of surgery, needle electrodes were inserted into the superior and inferior rectus muscles percutaneously, and cotton-covered electrodes were implanted into the oculomotor nerve proximal to the lesion. Compound muscle action potentials of the oculomotor nerve were measured continuously by monopolar stimulation. The lesion was mapped by direct stimulation, and the unresponsive area was excised. The amplitude of the compound muscle action potentials decreased during the resection but recovered postoperatively. After resection of the lesion, the compound muscle action potentials remained the same as they were preoperatively. No obvious postoperative oculomotor nerve palsy was observed. Conclusions This method of continuous monitoring of the function of the oculomotor nerve is simple to use and is suitable for lesions in close proximity to the oculomotor nerve. |
| Databáze: | OpenAIRE |
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