Research Article
Volume 12 Issue 11 - 2020
Intraoperative Neurophysiological Monitoring for Brainstem Tumor Surgeries Citation: Faisal
Faisal R Jahangiri1,2,3*, Katharine Pautler1,3, Elizabeth Ekvall1,3, Meredith Tucker3, Angela Goodlin1,3 and Afia Islam3
1Axis Neuromonitoring LLC, Richardson, TX, USA
2Global Innervations LLC, Dallas, TX, USA
3Department of Neuroscience, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, USA
*Corresponding Author: Faisal R Jahangiri, Department of Neuroscience, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, USA.
Received: October 01, 2020; Published: September 16, 2020




Abstract

Intraoperative Neurophysiological Monitoring (IONM) is routinely utilized to detect and prevent injuries to the nervous system during surgeries. IONM can be used to map and monitor cranial nerves that may be displaced due to large tumors or at risk of being damaged during tumor resection. Surgical procedures involving the removal of brainstem tumors may risks damage to the Facial nerve (cranial nerve VII) and Vestibulocochlear Nerve (Auditory nerve/cranial nerve VIII). Any injury to the Facial nerve can lead to facial muscle paralysis, loss of taste sensation, and tear production. Lack of tear production can result in damage to the cornea that may lead to loss of vision. Injury to the auditory nerve due to stretch, thermal, or ischemia (loss of blood supply) has a high risk of postoperative hearing deficits or hearing loss. IONM can be used to mitigate deficits when resecting various brainstem tumors. During brainstem tumor resections, a multimodality neuromonitoring approach may include Somatosensory Evoked Potentials (SSEPs), Motor Evoked Potentials (MEPs), Brainstem Auditory Evoked Potentials (BAEP), Cranial Nerve Electromyography (CN-EMG). IONM is crucial for minimizing and preventing damage to the cranial nerves, corticospinal tracts, and ischemia. The likelihood of injury, the severity of the damage and permanency of loss can be minimized with IONM by alerting the surgeon before the damage is irreversible. Large tumors, especially those larger than 2.5 cm, may shift anatomy in the brainstem and require lower cranial nerves from IX to XII neuromonitoring.

Keywords: IONM; Intraoperative Neurophysiological Monitoring; Somatosensory Evoked Potentials; SSEP; Transcranial Electrical Motor Evoked Potentials; TCeMEP; Corticobulbar Motor Evoked Potentials; CoMEP; Electromyographic; EMG; Brainstem Auditory Evoked Potentials; BAEP; Brain Tumor Neurosurgery

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Citation: Faisal R Jahangiri., et al. “Intraoperative Neurophysiological Monitoring for Brainstem Tumor Surgeries”. EC Neurology 12.11 (2020): 80-87.

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