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Monitoring of Sensory Evoked Potentials During Surgery of Skull Base Tumours

Published online by Cambridge University Press:  18 September 2015

F. Gentili ,
W.M. Lougheed ,
K. Yamashiro  and
C. Corrado
F. Gentili*
Affiliation:
Division of Neurosurgery, Department of Surgery, Toronto General Hospital, University of Toronto
W.M. Lougheed
Affiliation:
Division of Neurosurgery, Department of Surgery, Toronto General Hospital, University of Toronto
K. Yamashiro
Affiliation:
Division of Neurosurgery, Department of Surgery, Toronto General Hospital, University of Toronto
C. Corrado
Affiliation:
Division of Neurosurgery, Department of Surgery, Toronto General Hospital, University of Toronto
*
Room 225, 14 Eaton North, Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario, Canada M5G 2C4
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Abstract:

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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.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 12 , Issue S4 , November 1985 , pp. 336 - 340
Copyright
Copyright © Canadian Neurological Sciences Federation 1985

References

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