Correlation between intraoperative mapping and monitoring and functional outcomes following supratentorial glioma surgery

Autor: Han-Lin Wu, Po-Cheng Hsu, Sanford P C Hsu, Chun-Fu Lin, Kwong-Kum Liao, Kai-Ming Yang, Chen-Liang Chou, Tsui-Fen Yang
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Tzu-Chi Medical Journal, Vol 33, Iss 4, Pp 395-398 (2021)
Druh dokumentu: article
ISSN: 1016-3190
2223-8956
DOI: 10.4103/tcmj.tcmj_270_20
Popis: Objectives: Intraoperative neurophysiological monitoring (IONM) has long been regarded as the “gold standard” when resecting a supratentorial glioma, as it facilitates the goals of maximal tumor resection and preservation of sensorimotor function. The purpose of the present study was to evaluate the ability of motor evoked potentials (MEPs) monitoring or subcortical mapping (SCM), alone or in combination, to predict postoperative functional outcomes in glioma surgery. Materials and Methods: We retrospectively reviewed patients with supratentorial glioma that underwent craniotomy for tumor removal with IONM. Statistical analyses were used to evaluate whether the following criteria correlated with postoperative functional outcomes: Reduced amplitude (>50% reduction) or disappearance of MEPs (criterion 1), SCM with a stimulation intensity threshold less than 3 mA (criterion 2), the presence of both two phenomena (criterion 3), or either one of the two phenomena (criterion 4). Results: Ninety-two patients were included in this study, of whom 15 sustained new postoperative deficits, 4 experienced improved functional status, and 73 were unchanged. Postoperative functional status correlated significantly with all four criteria, and especially with criterion 3 (r = 0.647, P = 0.000). Sensitivity of IONM was better if using criteria 2 and 4, but specificity was better if using criteria 1 and 3. Criterion 3 had the most favorable overall results. Conclusion: Using statistical methodology, our study indicates that concomitant interpretation of MEPs and SCM is the most accurate predictor of functional outcomes following supratentorial glioma surgery. However, accurate interpretations of the monitoring results by experienced neurophysiologists are essential.
Databáze: Directory of Open Access Journals
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