Value of Free-Run Electromyographic Monitoring of Extraocular Cranial Nerves during Expanded Endonasal Surgery (EES) of the Skull Base
Abstract Objective To evaluate the value of free-run electromyography (f-EMG) monitoring of extraocular cranial nerves (EOCN) III, IV, and VI during expanded endonasal surgery (EES) of the skull base in reducing iatrogenic cranial nerve (CN) deficits. Design We retrospectiv...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2013-06-01
|
| Series: | Journal of Neurological Surgery Reports |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0033-1346975 |
| _version_ | 1811229273208389632 |
|---|---|
| author | Parthasarathy D. Thirumala Santhosh Kumar Mohanraj Miguel Habeych Kelley Wichman Yue-fang Chang Paul Gardner Carl Snyderman Donald J. Crammond Jeffrey Balzer |
| author_facet | Parthasarathy D. Thirumala Santhosh Kumar Mohanraj Miguel Habeych Kelley Wichman Yue-fang Chang Paul Gardner Carl Snyderman Donald J. Crammond Jeffrey Balzer |
| author_sort | Parthasarathy D. Thirumala |
| collection | DOAJ |
| description | Abstract
Objective To evaluate the value of free-run electromyography (f-EMG) monitoring of extraocular cranial nerves (EOCN) III, IV, and VI during expanded endonasal surgery (EES) of the skull base in reducing iatrogenic cranial nerve (CN) deficits.
Design We retrospectively identified 200 patients out of 990 who had at least one EOCN monitored during EES. We further separated patients into groups according to the specific CN monitored. In each CN group, we classified patients who had significant (SG) f-EMG activity as Group I and those who did not as Group II.
Results A total of 696 EOCNs were monitored. The number of muscles supplied by EOCNs that had SG f-EMG activity was 88, including CN III = 46, CN IV = 21, and CN VI = 21. There were two deficits involving CN VI in patients who had SG f-EMG activity during surgery. There were 14 deficits observed, including CN III = 3, CN IV = 2, and CN VI = 9 in patients who did not have SG f-EMG activity during surgery.
Conclusions f-EMG monitoring of EOCN during EES can be useful in identifying the location of the nerve. It seems to have limited value in predicting postoperative neurological deficits. Future studies to evaluate the EMG of EOCN during EES need to be done with both f-EMG and triggered EMG. |
| first_indexed | 2024-04-12T10:11:48Z |
| format | Article |
| id | doaj.art-053cdae5cc964a46a9b59e47b4fdb699 |
| institution | Directory Open Access Journal |
| issn | 2193-6358 2193-6366 |
| language | English |
| last_indexed | 2024-04-12T10:11:48Z |
| publishDate | 2013-06-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Journal of Neurological Surgery Reports |
| spelling | doaj.art-053cdae5cc964a46a9b59e47b4fdb6992022-12-22T03:37:17ZengGeorg Thieme Verlag KGJournal of Neurological Surgery Reports2193-63582193-63662013-06-01740104305010.1055/s-0033-1346975Value of Free-Run Electromyographic Monitoring of Extraocular Cranial Nerves during Expanded Endonasal Surgery (EES) of the Skull BaseParthasarathy D. Thirumala0Santhosh Kumar Mohanraj1Miguel Habeych2Kelley Wichman3Yue-fang Chang4Paul Gardner5Carl Snyderman6Donald J. Crammond7Jeffrey Balzer8Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USADepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USADepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USADepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USADepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USADepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USADepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USADepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USADepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USAAbstract Objective To evaluate the value of free-run electromyography (f-EMG) monitoring of extraocular cranial nerves (EOCN) III, IV, and VI during expanded endonasal surgery (EES) of the skull base in reducing iatrogenic cranial nerve (CN) deficits. Design We retrospectively identified 200 patients out of 990 who had at least one EOCN monitored during EES. We further separated patients into groups according to the specific CN monitored. In each CN group, we classified patients who had significant (SG) f-EMG activity as Group I and those who did not as Group II. Results A total of 696 EOCNs were monitored. The number of muscles supplied by EOCNs that had SG f-EMG activity was 88, including CN III = 46, CN IV = 21, and CN VI = 21. There were two deficits involving CN VI in patients who had SG f-EMG activity during surgery. There were 14 deficits observed, including CN III = 3, CN IV = 2, and CN VI = 9 in patients who did not have SG f-EMG activity during surgery. Conclusions f-EMG monitoring of EOCN during EES can be useful in identifying the location of the nerve. It seems to have limited value in predicting postoperative neurological deficits. Future studies to evaluate the EMG of EOCN during EES need to be done with both f-EMG and triggered EMG.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0033-1346975electromyographylower cranial nervesexpanded endonasal surgery |
| spellingShingle | Parthasarathy D. Thirumala Santhosh Kumar Mohanraj Miguel Habeych Kelley Wichman Yue-fang Chang Paul Gardner Carl Snyderman Donald J. Crammond Jeffrey Balzer Value of Free-Run Electromyographic Monitoring of Extraocular Cranial Nerves during Expanded Endonasal Surgery (EES) of the Skull Base Journal of Neurological Surgery Reports electromyography lower cranial nerves expanded endonasal surgery |
| title | Value of Free-Run Electromyographic Monitoring of Extraocular Cranial Nerves during Expanded Endonasal Surgery (EES) of the Skull Base |
| title_full | Value of Free-Run Electromyographic Monitoring of Extraocular Cranial Nerves during Expanded Endonasal Surgery (EES) of the Skull Base |
| title_fullStr | Value of Free-Run Electromyographic Monitoring of Extraocular Cranial Nerves during Expanded Endonasal Surgery (EES) of the Skull Base |
| title_full_unstemmed | Value of Free-Run Electromyographic Monitoring of Extraocular Cranial Nerves during Expanded Endonasal Surgery (EES) of the Skull Base |
| title_short | Value of Free-Run Electromyographic Monitoring of Extraocular Cranial Nerves during Expanded Endonasal Surgery (EES) of the Skull Base |
| title_sort | value of free run electromyographic monitoring of extraocular cranial nerves during expanded endonasal surgery ees of the skull base |
| topic | electromyography lower cranial nerves expanded endonasal surgery |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0033-1346975 |
| work_keys_str_mv | AT parthasarathydthirumala valueoffreerunelectromyographicmonitoringofextraocularcranialnervesduringexpandedendonasalsurgeryeesoftheskullbase AT santhoshkumarmohanraj valueoffreerunelectromyographicmonitoringofextraocularcranialnervesduringexpandedendonasalsurgeryeesoftheskullbase AT miguelhabeych valueoffreerunelectromyographicmonitoringofextraocularcranialnervesduringexpandedendonasalsurgeryeesoftheskullbase AT kelleywichman valueoffreerunelectromyographicmonitoringofextraocularcranialnervesduringexpandedendonasalsurgeryeesoftheskullbase AT yuefangchang valueoffreerunelectromyographicmonitoringofextraocularcranialnervesduringexpandedendonasalsurgeryeesoftheskullbase AT paulgardner valueoffreerunelectromyographicmonitoringofextraocularcranialnervesduringexpandedendonasalsurgeryeesoftheskullbase AT carlsnyderman valueoffreerunelectromyographicmonitoringofextraocularcranialnervesduringexpandedendonasalsurgeryeesoftheskullbase AT donaldjcrammond valueoffreerunelectromyographicmonitoringofextraocularcranialnervesduringexpandedendonasalsurgeryeesoftheskullbase AT jeffreybalzer valueoffreerunelectromyographicmonitoringofextraocularcranialnervesduringexpandedendonasalsurgeryeesoftheskullbase |