Fukuda Masafumi, Oishi Makoto, Hiraishi Tetsuya, Saito Akihiko, Fujii Yukihiko
Department of Neurosurgery, Brain Research Institute, University of Niigata, Japan.
Neurol Res. 2011 Jul;33(6):578-82. doi: 10.1179/016164110X12700393823697.
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.
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.
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.
FNMEP monitoring can predict facial nerve function not only immediately after surgery but also long-term.
本研究旨在阐明在颅底手术中经颅电刺激诱发的面神经运动诱发电位（FNMEPs）是否有助于预测面神经的长期功能。
我们分析了35例颅底肿瘤患者的FNMEP结果。平均随访时间为24.4个月。将螺旋电极置于C3或C4以及Cz位置，以施加超强刺激。从眼轮匝肌和口轮匝肌记录FNMEPs。
检查了最终与基线FNMEP比率与初始或长期面神经功能之间的相关性。术后初始面神经功能与眼轮匝肌（r = -0.53，P < 0.005）和口轮匝肌（r = -0.80，P < 0.001）的FNMEP比率显著相关。在长期随访期间，FNMEP比率与面神经功能之间的相关性仍然显著（眼轮匝肌：r = -0.43，P < 0.05；口轮匝肌：r = -0.71，P < 0.001）。在最终检查时，所有眼轮匝肌FNMEP比率保持在50%以上的患者被归入面神经功能满意（House-Brackmann分级I和II级）组。
FNMEP监测不仅可以在手术后立即预测面神经功能，还可以长期预测。
