CAJ | 학술논문

目的探讨听神经瘤术中监测面肌自发与诱发肌电图和听觉诱发电位的经验,分析术中面、听神经解剖功能保留的方法及评估电刺激强度和术后面神经功能的相关性及其安全性.方法回顾性分析我科从2001年10月到2012年10月,共对610例听神经瘤患者进行了术中监测面肌自发与诱发肌电图和听觉诱发电位.结果通过诱发肌电图及BAEP的监测,肿瘤的全切率为96.05%,面神经解剖保留率为95.39%,功能保留率(H-B分级I-II级)91.61%,术末面神经直接刺激脑干端1~3 V即引起肌电反应者,神经保留完整,预后良好.57例肿瘤直径<3 cm患者中,听神经解剖保留率70.18%,保留有用听力(功能保留率)31.58%.结论术中面肌自发与诱发肌电图和听觉诱发电位监测,提高了肿瘤的全切率和面听神经保留率,并可以减少或防止脑干功能的损伤.
목적탐토은신경류술중감측면기자발여유발기전도화은각유발전위적경험,분석술중면、은신경해부공능보류적방법급평고전자격강도화술후면신경공능적상관성급기안전성.방법회고성분석아과종2001년10월도2012년10월,공대610례은신경류환자진행료술중감측면기자발여유발기전도화은각유발전위.결과통과유발기전도급BAEP적감측,종류적전절솔위96.05%,면신경해부보류솔위95.39%,공능보류솔(H-B분급I-II급)91.61%,술말면신경직접자격뇌간단1~3 V즉인기기전반응자,신경보류완정,예후량호.57례종류직경<3 cm환자중,은신경해부보류솔70.18%,보류유용은력(공능보류솔)31.58%.결론술중면기자발여유발기전도화은각유발전위감측,제고료종류적전절솔화면은신경보류솔,병가이감소혹방지뇌간공능적손상.
Objective To report the authors’experiences with intraoperative muscles spontaneous and evoked facial electromyogram and brainstem auditory evoked potential monitoring in relation to facial and acoustic nerves functional pres?ervation during acoustic neuroma resection. Methods Between October 2001 and October 2012, 610 patients with acoustic neuromas underwent surgical resection with intraoperative facial electromyogram and brainstem auditory evoked potential monitoring. Results The rate of total tumor resection was 96.05%. With evoked electromyogram and brainstem auditory evoked potential monitoring, the facial nerve was anatomically intact in 95.39%of the patients with function preservation (H-B Grade I-II) in 91.61%of the patients. Successful induction of facial electromyogram at 1-3V after tumor resection was correlated to satisfactory postoperative facial nerve function. The acoustic nerve was anatomically intact in 70.18%of the 57 patients with small acoustic neuromas (<3 cm) with useful postoperative hearing in 31.58%. Conclusion Intraopera?tive facial electromyogram and brainstem auditory evoked potential monitoring are beneficial to improve the rate of total tu?mor removal and facial nerve preservation. Intraoperative neurophysiologic monitoring can also help reduce the chance of brainstem injury.