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Intraoperative Neurophysiologic Monitoring in Predicting Dysphagia After Brainstem and Fourth Ventricle Surgery.
Lapteva, Kristina; Gavrjushin, Andrey; Pitskhelauri, David; Birg, Tatiana; Danilov, Gleb; Ogurtsova, Anna; Strunina, Yulia; Fomochkina, Ludmila.
Afiliación
  • Lapteva K; Department of Clinical Neurophysiology, N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russian Federation. Electronic address: laptevakr@gmail.com.
  • Gavrjushin A; Department of Neuro-oncology, N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russian Federation.
  • Pitskhelauri D; Department of Neuro-oncology, N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russian Federation.
  • Birg T; Department of Intensive Care Unit, N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russian Federation.
  • Danilov G; Laboratory of Biomedical Informatics and Artificial Intelligence, N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russian Federation.
  • Ogurtsova A; Department of Clinical Neurophysiology, N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russian Federation.
  • Strunina Y; Laboratory of Biomedical Informatics and Artificial Intelligence, N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russian Federation.
  • Fomochkina L; Department of Otorhinolaryngology, N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russian Federation.
World Neurosurg ; 180: e334-e340, 2023 Dec.
Article en En | MEDLINE | ID: mdl-37757944
OBJECTIVE: Dysphagia represents the main complication of posterior fossa neurosurgery. Adequate diagnosis of this complication is warranted to prevent untimely extubation with subsequent aspiration. Intraoperative neurophysiologic monitoring (IONM) modalities may be used for this purpose. However, it is not known which IONM modality may be significant for diagnosis. This study aimed to define the most significant IONM modality for dysphagia prognostication after posterior fossa neurosurgery. METHODS: The analysis included 46 patients (34 with tumors of the fourth ventricle and 12 with brainstem localization) who underwent surgical excision of the tumor. Neurologic symptoms before and after neurosurgery were noted and magnetic resonance imaging with the subsequent volume estimation of the removed mass was performed, followed by an IONM findings analysis (mapping of the nucleus of the caudal cranial nerves [CN] and corticobulbar motor-evoked potentials [CoMEP]). RESULTS: Aggravation of dysphagia was noted in 24% of the patients, more often in patients with tumor localization in the fourth ventricle (26%) than in those with brainstem mass lesions (16%). Mapping of the caudal cranial nerve nuclei did not correlate with the dysfunction of these structures. CoMEP was significantly associated with the neurologic state of the CN. The decrease in CoMEP is a significant prognostic factor for postoperative bulbar symptoms appearance or aggravation. CONCLUSIONS: Mapping the CN is an important identification tool. The CoMEP modality should be used intraoperatively to determine the functional state of the CN and predict postoperative dysphagia.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos de Deglución / Monitorización Neurofisiológica Intraoperatoria / Neoplasias / Enfermedades del Sistema Nervioso Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: World Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos de Deglución / Monitorización Neurofisiológica Intraoperatoria / Neoplasias / Enfermedades del Sistema Nervioso Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: World Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos