Strauss G, Strauss M, Lüders C, Stopp S, Shi J, Dietz A, Lüth T
Klinik und Poliklinik für HNO-Heilkunde/Plastische Operationen, Universität Leipzig.
Laryngorhinootologie. 2008 Oct;87(10):711-8. doi: 10.1055/s-2007-995751. Epub 2008 May 26.
PROBLEM DEFINITION: The goal of this work is the integration of the information of the intraoperative EMG monitoring of the facial nerve into the radiological data of the petrous bone. The following hypotheses are to be examined: (I) the N. VII can be determined intraoperatively with a high reliability by the stimulation-probe. A computer program is able to discriminate true-positive EMG signals from false-positive artifacts. (II) The course of the facial nerve can be registered in a three-dimensional area by EMG signals at a nerve model in the lab test. The individual items of the nerve can be combined into a route model. The route model can be integrated into the data of digital volume tomography (DVT).
(I) Intraoperative EMG signals of the facial nerve were classified at 128 measurements by an automatic software. The results were correlated with the actual intraoperative situation. (II) The nerve phantom was designed and a DVT data set was provided. Phantom was registered with a navigation system (Karl Storz NPU, Tuttlingen, Germany). The stimulation probe of the EMG-system was tracked by the navigation system. The navigation system was extended by a processing unit (MiMed, Technische Universität München, Germany). Thus the classified EMG parameters of the facial route can be received, processed and be generated to a model of the facial nerve route. The operability was examined at 120 (10 x 12) measuring points.
The evaluation of the examined algorithm for classification EMG-signals of the facial nerve resulted as correct in all measuring events. In all 10 attempts it succeeded to visualize the nerve route as three-dimensional model. The different sizes of the individual measuring points reflect the appropriate values of Istim and UEMG correctly.
This work proves the feasibility of an automatic classification of an intraoperative EMG signal of the facial nerve by a processing unit. Furthermore the work shows the feasibility of tracking of the position of the stimulation probe and its integration into amodel of the route of the facial nerve (e. g. DVT). The rediability, with which the position of the nerve can be seized by the stimulation probe, is also included into the resulting route model.
问题定义：这项工作的目标是将面神经术中肌电图监测信息与颞骨的放射学数据整合。将检验以下假设：（I）通过刺激探头可在术中以高可靠性确定面神经。计算机程序能够区分真正的肌电图信号与假阳性伪迹。（II）在实验室测试中，通过神经模型上的肌电图信号可在三维区域记录面神经的走行。神经的各个部分可组合成一个路径模型。该路径模型可整合到数字容积断层扫描（DVT）数据中。
（I）通过自动软件对128次测量的面神经术中肌电图信号进行分类。将结果与术中实际情况进行关联。（II）设计神经模型并提供一个DVT数据集。用导航系统（德国图特林根卡尔·史托斯NPU）对模型进行配准。肌电图系统的刺激探头由导航系统跟踪。导航系统通过一个处理单元（德国慕尼黑工业大学的MiMed）进行扩展。由此可接收、处理面神经路径的分类肌电图参数并生成面神经路径模型。在120个（10×12）测量点检验其可操作性。
对面神经肌电图信号分类算法的评估在所有测量事件中均正确。在所有10次尝试中，均成功将神经路径可视化为三维模型。各个测量点的不同大小正确反映了刺激电流（Istim）和肌电图电压（UEMG）的相应值。
这项工作证明了通过处理单元对面神经术中肌电图信号进行自动分类的可行性。此外，该工作还展示了跟踪刺激探头位置并将其整合到面神经路径模型（如DVT）中的可行性。刺激探头捕捉神经位置的可靠性也包含在最终的路径模型中。
