Neurophysiological intraoperative monitoring during an optic nerve schwannoma removal
| Autor: | Daniel San-Juan, Adolfo Josué Orozco Garduño, Jesús Alejandro López Pizano, Martha Tena-Suck, Jonathan Villanueva Domínguez, Manuel Escanio Cortés, Juan Luis Gómez-Amador, Maricarmen Fernández González-Aragón |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
medicine.medical_specialty Visual acuity Intraoperative Neurophysiological Monitoring genetic structures Health Informatics Amaurosis Fugax Schwannoma Critical Care and Intensive Care Medicine 03 medical and health sciences 0302 clinical medicine Ophthalmology medicine Humans Brain Neoplasms business.industry Optic Nerve Neoplasms Cranial nerves Optic Nerve Optokinetic reflex medicine.disease Optic Nerve Neoplasm Electric Stimulation eye diseases Surgery Anesthesiology and Pain Medicine medicine.anatomical_structure 030220 oncology & carcinogenesis Peripheral nervous system Optic nerve Evoked Potentials Visual Female sense organs medicine.symptom business Neurilemmoma 030217 neurology & neurosurgery Intraoperative neurophysiological monitoring |
| Zdroj: | Journal of Clinical Monitoring and Computing. 31:1059-1064 |
| ISSN: | 1573-2614 1387-1307 |
| Popis: | This paper reports the case of a patient with optic nerve schwannoma and the first use of neurophysiological intraoperative monitoring of visual evoked potentials during the removal of such tumor with no postoperative visual damage. Schwannomas are benign neoplasms of the peripheral nervous system arising from the neural crest-derived Schwann cells, these tumors are rarely located in the optic nerve and the treatment consists on surgical removal leading to high risk of damage to the visual pathway. Case report of a thirty-year-old woman with an optic nerve schwannoma. The patient underwent surgery for tumor removal on the left optic nerve through a left orbitozygomatic approach with intraoperative monitoring of left II and III cranial nerves. We used Nicolet Endeavour CR IOM (Carefusion, Middleton WI, USA) to performed visual evoked potentials stimulating binocularly with LED flash goggles with the patient´s eyes closed and direct epidural optic nerve stimulation delivering rostral to the tumor a rectangular current pulse. At follow up examinations 7 months later, the left eye visual acuity was 20/60; Ishihara score was 8/8 in both eyes; the right eye photomotor reflex was normal and left eye was mydriatic and arreflectic; optokinetic reflex and ocular conjugate movements were normal. In this case, the epidural direct electrical stimulation of optic nerve provided stable waveforms during optic nerve schwannoma resection without visual loss. |
| Databáze: | OpenAIRE |
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