[神经生理术中监测以保留颅底手术中的颅神经功能]
[Neurophysiologic intraoperative monitoring to preserve cranial nerve function in base of skull surgery].
作者信息
Schipper J, Ridder G J, Arapakis I, Gellrich N-C, Spetzger U, Maier W
机构信息
Interdisziplinäres Zentrum für Schädelbasis- und Craniofaciale Chirurgie am Universitätsklinikum Freiburg.
出版信息
HNO. 2004 Oct;52(10):897-907. doi: 10.1007/s00106-004-1074-4.
BACKGROUND
Neurophysiologic intraoperative monitoring (NIM) has gone through a renaissance since the advent of computer technology. Currently, both motor and sensory cranial nerves, including the IInd and VIIIth cranial nerves, can be intraoperatively controlled by means of small and mobile systems.
PATIENTS AND METHODS
In order to estimate the value of NIM using the new generation of computer systems, we analyzed the records of 379 patients who underwent skull base surgery since 1996. These comprised NIM of the IInd, VIIth, VIIIth cranial nerves in most cases and of the IXth, Xth, XIth, and XIIth cranial nerves in selected cases.
RESULTS
Whereas 72% of these cases demonstrated changes in the recorded intraoperative NIM signals, only 29% of them gave evidence of either clinical or electrophysiological neural function alterations during the postoperative follow-up.
CONCLUSIONS
NIM is the only available system capable of providing the surgeon with instant intraoperative neural status-related feedback.
背景
自计算机技术出现以来，神经生理术中监测（NIM）经历了复兴。目前，包括第二和第八对颅神经在内的运动和感觉颅神经都可以通过小型移动系统在术中进行监测。
患者与方法
为了评估使用新一代计算机系统进行神经生理术中监测的价值，我们分析了自1996年以来接受颅底手术的379例患者的记录。这些记录大多包括第二、第七、第八对颅神经的神经生理术中监测，部分记录还包括第九、第十、第十一和第十二对颅神经的监测。
结果
虽然这些病例中有72%在术中记录的神经生理术中监测信号出现了变化，但术后随访期间只有29%的病例有临床或电生理神经功能改变的证据。
结论
神经生理术中监测是唯一能够为外科医生提供即时术中神经状态相关反馈的可用系统。
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