ENT MONITORING
Introduction
ENT surgeries often occur in a complex area through which several
cranial nerves pass, including the VIIth (facial) and of course the
VIIIth (auditory) cranial nerves.
Indications
IONM may be useful in any ENT surgery where cranial nerves or brainstem
function is placed at risk. It's introduction was prompted and is
particularly well documented in resection for acoustic neuromas where
the incidence of facial nerve injury is high. It is also useful with
other cerebello-pontine angle tumor resections.
Modalities Used
SEP,
S-EMG, T-EMG, BAER, ECoch,
Auditory NAP
BAERs aid in identifying
and protecting residual hearing function. Stimulation of
tumor mass (TEMG) to locate displaced nerve aids in preserving facial
nerve function.
R. O'Brien MD
References
Harner, SG, et al. Improved preservation of facial
nerve functions with use of electrical monitoring during removal of
acoustic neuromas. Mayo Clin. Proc., 1987,62, 92-102
Yingling, CD, Gardi, JN. Intraoperative monitoring
of facial and cochlear nerves during acoustic neuroma surgery.
Otolryngol. Clin. N. Am. 1992, 25, 413-448 |