Document Type
Article
Publication Date
5-16-2016
Abstract
Intraoperative neurophysiological monitoring during endoscopic, endonasal approaches to the skull base is both feasible and safe. Numerous reports have recently emerged from the literature evaluating the efficacy of different neuromonitoring tests during endonasal procedures, making them relatively well-studied. The authors report on a comprehensive, multimodality approach to monitoring the functional integrity of at risk nervous system structures, including the cerebral cortex, brainstem, cranial nerves, corticospinal tract, corticobulbar tract, and the thalamocortical somatosensory system during endonasal surgery of the skull base. The modalities employed include electroencephalography, somatosensory evoked potentials, free-running and electrically triggered electromyography, transcranial electric motor evoked potentials, and auditory evoked potentials. Methodological considerations as well as benefits and limitations are discussed. The authors argue that, while individual modalities have their limitations, multimodality neuromonitoring provides a real-time, comprehensive assessment of nervous system function and allows for safer, more aggressive management of skull base tumors via the endonasal route.
Recommended Citation
Singh, Harminder; Vogel, Richard W.; Lober, Robert M.; Doan, Adam T.; Matsumoto, Craig I.; Kenning, Tyler J.; and Evans, James J., "Intraoperative Neurophysiological Monitoring for Endoscopic Endonasal Approaches to the Skull Base: A Technical Guide." (2016). Department of Neurosurgery Faculty Papers. Paper 84.
https://jdc.jefferson.edu/neurosurgeryfp/84
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
PubMed ID
27293965
Comments
This article has been peer reviewed. It is the author’s final published version in Scientifica
Volume 2016, May 2016, Article number 1751245.
The published version is available at DOI: 10.1155/2016/1751245. Copyright © Singh et al.