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术中神经监测下臂丛神经鞘瘤摘除术的可行性

Feasibility of Brachial Plexus Schwannoma Enucleation With Intraoperative Neuromonitoring.

作者信息

Lee Doh Young, Chi Jeong-Yeon, Seok Jungirl, Han Sungjun, Lee Min-Hyung, Jeong Woo-Jin, Jung Young Ho

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, SMG-SNU Boramae Medical Center, Seoul, Korea.

Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.

出版信息

Clin Exp Otorhinolaryngol. 2020 May;13(2):203-208. doi: 10.21053/ceo.2019.01207. Epub 2020 Apr 4.

Abstract

OBJECTIVES

To evaluate the feasibility of brachial plexus schwannoma enucleation under intraoperative neuromonitoring.

METHODS

Five patients who were treated for brachial plexus schwannoma under intraoperative neuromonitoring from 2008 to 2018 were included in this retrospective review. Neuromonitoring was performed with a 100-μV event threshold of the neuromonitoring system (NIM-2 or 3) at the deltoid, biceps brachii, triceps brachii, and brachioradialis muscles. Patient characteristics, tumor size and location, intraoperative neuromonitoring findings, and postoperative function were evaluated.

RESULTS

The intraoperative neuromonitoring findings were in accordance with the preoperative assessment of the included nerve root. Three patients had no postoperative morbidity, one patient had temporary paresthesia of the forearm for 2 months, and one patient mild loss of grip strength for 1 month.

CONCLUSION

Intraoperative neuromonitoring of the arm and forearm muscles during enucleation of brachial plexus schwannoma promoted confident and successful surgery with minimal postoperative morbidity.

摘要

目的

评估术中神经监测下臂丛神经鞘瘤摘除术的可行性。

方法

本回顾性研究纳入了2008年至2018年期间在术中神经监测下接受臂丛神经鞘瘤治疗的5例患者。在三角肌、肱二头肌、肱三头肌和肱桡肌处使用神经监测系统(NIM - 2或3),以100μV的事件阈值进行神经监测。评估患者特征、肿瘤大小和位置、术中神经监测结果以及术后功能。

结果

术中神经监测结果与所累及神经根的术前评估一致。3例患者术后无并发症,1例患者前臂出现2个月的暂时性感觉异常,1例患者握力轻度下降1个月。

结论

臂丛神经鞘瘤摘除术中对臂部和前臂肌肉进行术中神经监测,可使手术顺利进行并取得成功,且术后并发症最少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e9e/7248612/23e8ead08da2/ceo-2019-01207f1.jpg

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