Effect of click-polarity on abnormality of intraoperatively monitored brainstem acoustic evoked potentials

The configuration of brainstem acoustic evoked potentials (BAEP) is influenced by the type of click stimuli used and may thus affect detectability of abnormalities. In a group of 19 patients with lesions in the posterior fossa BAEP were recorded pre- and intraoperatively. Repeat recordings were performed in each patient in two alternating series with rarefaction and condensation click stimuli. The findings demonstrated that intraoperative potential changes in latency and amplitude were different between the two stimulation modes, but did not vary significantly in their incidence. It was also not possible to predict from the preoperative BAEP which click polarity would demonstrate intraoperative changes more markedly, taking latency and amplitude as parameters. Two conclusions are drawn from this study: None of the two stimulation modes is superior in detecting intraoperative changes and therefore no recommendation can be made which click polarity to use. When working with only one click polarity it is recommended to use occasional control recordings with the other click polarity.