Cueva R A, Morris G F, Prioleau G R
Department of Head and Neck Surgery, Southern California Permanente Medical Group, San Diego 92120, USA.
Am J Otol. 1998 Mar;19(2):202-7.
To assess the efficacy and safety of a new atraumatic, self-retaining cranial nerve electrode for direct cochlear nerve monitoring during cerebellopontine angle surgery.
Prospective clinical investigation.
The Skull Base Surgery Center at Kaiser Permanente, San Diego, a tertiary referral center for neurotologic and skull-base surgery within Southern California Permanente Medical Group.
Eighteen patients, with aidable preoperative hearing, underwent direct cochlear nerve monitoring with this new electrode during cerebellopontine angle surgery for a variety of diagnoses.
Intraoperative observations of cochlear nerve action potential amplitude and latency were recorded. Preoperative and 1-month postoperative audiograms were compared to assess the degree of hearing preservation. Postoperative facial nerve function was assessed using the House-Brackmann method.
Good auditory function was preserved in four of eight acoustic tumors, with poor hearing preserved in two additional patients. Good auditory function was preserved in the remaining ten patients. Cochlear nerve action potential amplitudes between 5 and 70 microV were recorded. Postoperative facial nerve function was House-Brackmann class I-II in all 18 patients.
The authors find this new electrode to be safe and effective for monitoring cochlear nerve function during cerebellopontine angle surgery.
评估一种新型无创、自固定的颅神经电极在桥小脑角手术中直接监测蜗神经的有效性和安全性。
前瞻性临床研究。
圣地亚哥凯撒医疗机构的颅底手术中心，该中心是南加州永久医疗集团内耳科和颅底手术的三级转诊中心。
18例术前有听力的患者，在桥小脑角手术中使用这种新型电极进行蜗神经直接监测，手术诊断各异。
记录术中蜗神经动作电位的幅度和潜伏期。比较术前和术后1个月的听力图，以评估听力保留程度。采用House-Brackmann法评估术后面神经功能。
8例听神经瘤患者中有4例保留了良好的听觉功能，另有2例患者保留了较差的听力。其余10例患者保留了良好的听觉功能。记录到蜗神经动作电位幅度在5至70微伏之间。18例患者术后面神经功能均为House-Brackmann I-II级。
作者发现这种新型电极在桥小脑角手术中监测蜗神经功能安全有效。
