Gentili F, Lougheed W M, Yamashiro K, Corrado C
Can J Neurol Sci. 1985 Nov;12(4):336-40. doi: 10.1017/s0317167100035484.
Despite advances in instrumentation and the use of microsurgical techniques, neurosurgical procedures involving extensive areas of skull base or other critical areas of brain still carry significant risk for neurological injury. The use of intraoperative recording of sensory evoked potentials (SEP) has been advocated to monitor neurologic function during these major neurosurgical procedures to reduce the risk of injury to neural structures. This report summarizes our experience with intraoperative monitoring of SEP in over 200 patients, and details our findings in a group of 12 patients with skull base and posterior fossa tumours. Somatosensory evoked potentials (SSEP) were monitored in all patients, and brain stem auditory evoked potentials (BAEP) in five. While minor changes in BAEP and SSEP parameters were noted in most patients, significant changes occurred in five. Irreversible loss of BAEP in one patient was associated with complete hearing loss postoperatively. Marked, persistent alteration of both BAEP and SSEP was associated with postoperative brainstem dysfunction. No patient with stable BAEP and SSEP at the end of the procedure suffered additional neurological deficit. We conclude that intraoperative SEP monitoring may be valuable in minimizing neural injury during major neurosurgical procedures.
尽管在仪器设备和显微外科技术的应用方面取得了进展，但涉及颅底广泛区域或大脑其他关键区域的神经外科手术，仍然存在显著的神经损伤风险。术中感觉诱发电位（SEP）记录已被提倡用于在这些大型神经外科手术期间监测神经功能，以降低神经结构损伤的风险。本报告总结了我们对200多名患者进行术中SEP监测的经验，并详细阐述了我们在一组12例颅底和后颅窝肿瘤患者中的发现。所有患者均监测体感诱发电位（SSEP），5例患者监测脑干听觉诱发电位（BAEP）。虽然大多数患者的BAEP和SSEP参数有轻微变化，但有5例出现了显著变化。1例患者BAEP不可逆丧失与术后完全听力丧失相关。BAEP和SSEP均出现明显、持续的改变与术后脑干功能障碍相关。手术结束时BAEP和SSEP稳定的患者均未出现额外的神经功能缺损。我们得出结论，术中SEP监测对于在大型神经外科手术中尽量减少神经损伤可能具有重要价值。
