术中使用带磨头的针电极肌电图刺激来识别面神经。
Intraoperative identification of the facial nerve by needle electromyography stimulation with a burr.
作者信息
Khamgushkeeva N N, Anikin I A, Korneyenkov A A
出版信息
G Chir. 2016 Jan-Feb;37(1):19-26. doi: 10.11138/gchir/2016.37.1.019.
UNLABELLED
The purpose of this research is to improve the safety of surgery for patients with a pathology of the middle and inner ear by preventing damage to the facial nerve by conducting intraoperative monitoring of the facial nerve by needle electromyography with continuous stimulation with a burr.
PATIENTS AND METHODS
The clinical part of the prospective study was carried out on 48 patients that were diagnosed with suppurative otitis media. After the surgery with intraoperative monitoring, the facial nerve with an intact bone wall was stimulated electrically in the potentially dangerous places of damage. Minimum (threshold) stimulation (mA) of the facial nerve with a threshold event of 100 μV was used to register EMG events. The anatomical part of the study was carried out on 30 unformalinized cadaver temporal bones from adult bodies. The statistical analysis of obtained data was carried out with parametric methods (Student's t-test), non-parametric correlation (Spearman's method) and regression analysis.
RESULTS
It was found that 1 mA of threshold amperage corresponded to 0.8 mm thickness of the bone wall of the facial canal. Values of transosseous threshold stimulation in potentially dangerous sections of the injury to the facial nerve were obtained.
CONCLUSION
These data lower the risk of paresis (paralysis) of the facial muscles during otologic surgery.
未标注
本研究的目的是通过使用带连续电钻刺激的针电极肌电图对面神经进行术中监测，防止中耳和内耳病变患者在手术中面神经受损，从而提高手术安全性。
患者与方法
前瞻性研究的临床部分对48例被诊断为化脓性中耳炎的患者进行。在术中监测的手术后，在面神经可能受损的危险部位对完整骨壁下的面神经进行电刺激。使用阈值事件为100μV的面神经最小（阈值）刺激（mA）来记录肌电图事件。研究的解剖部分对30个来自成年尸体的未用甲醛固定的颞骨进行。对获得的数据进行参数方法（学生t检验）、非参数相关性（斯皮尔曼方法）和回归分析。
结果
发现1mA的阈值电流对应于面神经管骨壁0.8mm的厚度。获得了面神经损伤潜在危险部位的经骨阈值刺激值。
结论
这些数据降低了耳科手术中面部肌肉麻痹的风险。
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