Department of Neurological Surgery and Spine Unit, Hospital Universitario Marqués de Valdecilla, Santander, Spain; Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain.
Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain; Department of Psychiatry, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
World Neurosurg. 2022 Aug;164:353-366. doi: 10.1016/j.wneu.2022.06.012. Epub 2022 Jun 10.
Homonymous hemianopia has been reported after brain tumor resection with a significant effect on quality of life. Nevertheless, no standardized methods exist for intraoperative optical radiation mapping. The purpose of this article is to describe a new intraoperative task for visual mapping and to review the existing literature. A Central and Peripheral Image task was used to map optic radiations during brain tumor resection in 3 patients. A systematic review was performed following PRISMA 2020 guidelines, with 25 of 449 articles included. Optic radiations were identified in all patients and preserved in all but one, in whom the extent of resection prevailed. The literature review exposed 2 methods to assess visual function: visual evoked potentials (VEP) and direct electric stimulation (DES), with 13 and 12 articles and 341 and 63 patients, respectively. Hemianopia was developed in 13.49% of patients with VEP versus 1.59% of patients with DES. The use of DES might be associated with a better outcome (level IV evidence). However, standardization of intraoperative tasks during DES could be improved. In this context, the Central and Peripheral Image task might be an adequate tool for the resection of tumors affecting the optic radiations.
同明偏盲在脑肿瘤切除术后有报道,对生活质量有重大影响。然而,目前尚不存在用于术中光辐射定位的标准化方法。本文旨在描述一种新的术中视觉定位任务,并复习现有文献。在 3 例脑肿瘤切除术中使用中央和外周图像任务对视辐射进行定位。按照 PRISMA 2020 指南进行系统回顾,共纳入 449 篇文章中的 25 篇。所有患者均识别出视辐射并保留下来,但有 1 例患者除外,该患者的切除范围占优势。文献回顾揭示了 2 种评估视觉功能的方法:视觉诱发电位(VEP)和直接电刺激(DES),分别有 13 篇和 12 篇文章,以及 341 例和 63 例患者。VEP 组有 13.49%的患者出现偏盲,DES 组有 1.59%的患者出现偏盲。DES 的使用可能与更好的结果相关(IV 级证据)。然而,DES 期间术中任务的标准化可以得到改善。在这种情况下,中央和外周图像任务可能是影响视辐射的肿瘤切除的一种合适工具。