CAJ | 학술논문

目的探讨静吸复合麻醉下经颅电刺激面神经运动诱发电位(FNMEP)监测在小脑脑桥角(CPA)区肿瘤手术中是否可预测术后面神经功能.方法 52例CPA区肿瘤患者,术中行FNMEP监测面神经功能,术后参照H-B面神经分级标准,对术前、后面神经功能的改变和FNMEP波幅术后/术前比率之间的关系进行统计分析.结果 FNMEP波幅变化与术后面神经功能差异有统计学意义(P ＜0.001).FNMEP波幅比率＜50％,预示术后面神经功能障碍;比率＞50％,预示术后面神经功能正常或仅为轻度功能障碍(H-BⅠ级或Ⅱ级).结论 FNMEP可预测术后面神经功能,可对现有术中面神经功能的监测技术起到完善、补充的作用.
목적 탐토정흡복합마취하경로전자격면신경운동유발전위(FNMEP)감측재소뇌뇌교각(CPA)구종류수술중시부가예측술후면신경공능.방법 52례CPA구종류환자,술중행FNMEP감측면신경공능,술후삼조H-B면신경분급표준,대술전、후면신경공능적개변화FNMEP파폭술후/술전비솔지간적관계진행통계분석.결과 FNMEP파폭변화여술후면신경공능차이유통계학의의(P ＜0.001).FNMEP파폭비솔＜50％,예시술후면신경공능장애;비솔＞50％,예시술후면신경공능정상혹부위경도공능장애(H-BⅠ급혹Ⅱ급).결론 FNMEP가예측술후면신경공능,가대현유술중면신경공능적감측기술기도완선、보충적작용.
Objective To determine whether monitoring facial nerve motor-evoked potential (FNMEP) elicited by transcranial electrical stimulation during cerebellopontine angel (CPA) tumor surgery is useful for predicting postoperative facial nerve outcome.Methods In 52 patients undergoing CPA tumor surgery,FNMEP was delivered through transcranial electrical stimulation.FNMEP was recorded from the oris muscles and the mentalis muscles.The correlation between the final-to-baseline ratio and 7 days postoperative facial nerve function was examined.Preoperative and postoperative functions were documented using the House-Brackmann grading system.Spearman correlation coefficients were used to evaluate whether the postoperative facial fuction was correlated with the FNMEP ratio in patients with CPA tumor.Resluts The valid FNMEPs were obtained in 50 of the 52 recordings from the orbicularis oris muscle in the group of patients with CPA tumor.The postoperative facial nerve function was correlated significantly with the FNMEP ratio in the orbicularis oris muscles (P ＜0.001).An FNMEP rate of ＜50％ consistently predicted postoperative facial palsy.If the FNMEP ratio remained at ＞ 50％,all patients had satisfactory facial nerve function (House and Brackmann grades Ⅰ and Ⅱ).Using 50％ of baseline amplitude criteria,significant facial deficits were predicted with a sensitivity/specificity of 1.00/0.88.Conclusions Introperative FNMEP monitoring could provide an ongoing surgeon-independent of facial nerve function and be useful for predicting facial nerve function after CPA tumor surgery.This method should be used as an adjunct to direct electrical facial nerve stimulation and continuous electromyographic monitoring of facial nerve target muscles.