Jul, 2011
Intraoperative facial nerve motor evoked potential monitoring during skull base surgery predicts long-term facial nerve function outcomes.
Neurological research
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- Volume
- 33
- Number
- 6
- First page
- 578
- Last page
- 82
- Language
- English
- Publishing type
- Research paper (scientific journal)
- DOI
- 10.1179/016164110X12700393823697
OBJECTIVES: This study was designed to clarify whether facial nerve motor evoked potentials (FNMEPs) elicited by transcranial electrical stimulation during skull base surgery are useful for predicting long-term facial nerve function. METHODS: We analyzed FNMEP findings in 35 patients with skull base tumors. Mean follow-up was 24.4 months. Corkscrew electrodes positioned at C3 or C4 and Cz were used to deliver supramaximal stimuli. FNMEPs were recorded from the orbicularis oculi and oris muscles. RESULTS: The correlation between the final-to-baseline FNMEP ratio and initial or long-term facial nerve function was examined. Initial post-operative facial nerve function correlated significantly with the FNMEP ratios in the orbicularis oculi (r = -0.53, P < 0.005) and orbicularis oris (r = -0.80, P < 0.001) muscles. The correlations between FNMEP ratios and facial nerve function remained significant during long-term follow-up (orbicularis oculi muscle: r = -0.43, P < 0.05; orbicularis oris muscle: r = -0.71, P < 0.001). All patients in whom the FNMEP ratio in the orbicularis oculi muscles remained above 50% were assigned to the satisfactory facial nerve function (House-Brackmann Grades i and ii) group at the final examination. DISCUSSION: FNMEP monitoring can predict facial nerve function not only immediately after surgery but also long-term.
- Link information
- ID information
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- DOI : 10.1179/016164110X12700393823697
- Pubmed ID : 21708066