面部神经功能和电刺激在静脉瘤手术期间的相关性
Valerie Dahm1,2, Justin T Lui1,3, Jennifer L Spiegel1,4
1Department of Otolaryngology-Head & Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
概括
在前庭神经瘤手术期间,面部神经的监测至关重要. 更高的电生理振幅预测了更好的长期面部神经功能,有助于患者期望管理.
科学领域:
- 神经外科 神经外科
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 电力生理学 电力生理学
背景情况:
- 静脉瘤 (VS) 手术需要精确的面部神经监测.
- 电生理学参数可以预测术后面部神经功能.
研究的目的:
- 在VS手术中确定最佳面部神经监测的电生理学参数.
- 建立面部神经结果的预测值.
主要方法:
- 追溯性研究76名接受VS切除的患者.
- 使用电肌图和直接电刺激进行面部神经监测.
- 面部神经刺激幅度与House-Brackmann (HB) 面部神经功能分级的相关性.
主要成果:
- 较高的振幅 (≥1024μV) 与长期HB I-II功能>90%的概率相关.
- 较低的振幅 (例如,128μV) 与长期HB III-IV功能的53%概率相关.
- 手术后的结局包括HB I (21%),HB II (40%),HB III (18%),HB IV (9%) 和HB V (12%). 这三种类型的肝炎是最常见的.
结论:
- 面部神经监测在VS手术期间提供客观数据.
- 更高的刺激幅度表明更有利的长期面部神经结果.
- 500微伏和1000微伏的振幅作为预测HB I-II功能的有用切割值 (分别为84%和90%的概率).
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