摘要
目的使用多导监护仪进行桥脑小脑角肿瘤的多组颅神经术中监测,以监测面神经为主。方法总结60例桥小脑角肿瘤术中监测的经验,其中听神经瘤为47例。使用Viking-IV型多导监护仪,监测自发和诱发的面肌、咬肌和斜方肌肌电图。诱发肌电图使用单极恒压电刺激。结果单极恒压电刺激诱发肌电图可以精确判断面神经的位置,损伤较机械刺激小。刺激量由大到小,距离由远及近,定位准确、及时,并可判断面神经预后。本组结果提示术毕在面神经出脑干端刺激时,刺激量在1V,0.1ms时,术后2周面肌功能在H-B分级的I级。术中监测后面神经保留率为93.6%。其他运动性颅神经均解剖保留。结论术中面神经功能监测是提高肿瘤全切率和面神经保留率的理想方法,并可提供面神经术后康复的依据。
Objective The aim of intraoperative monitoring is to preserve facial nerve and other cranial nerves at the basis of total tumor removal. Methods We reported 60 cases of cerebellopontine tumors with intraoperative multimodality monitoring of facial nerve, acoustic nerve and trigeminal nerve. 47 patients are acoustic neurinomas and 46 of them underwent operation with retrosigmoid approach.Results Constant monopolar voltage stimuli can identify the position of facial nerve accurately. The electrical injury to facial nerve is smaller than that of mechanic stimulate. The stimulate intensity is from low to high step by step and the distance to nerve is from remote to vicinity. If the stimulate is 1V(0.1ms), the facial nerve function is I grade of House Brackmaan classification. The ratio of facial nerve preservation is 93.6%. Conclusion The intraoperative monitoring of facial nerve is an excellent method to preserve the anatomy of facial and other nerves. Stimulate intensity at the exit of facial nerve from brainstem side can predict the acute and final facial nerve function. It can also forecast the outcome of facial nerve rehabilitation.
出处
《中国临床康复》
CSCD
2002年第8期1142-1143,共2页
Chinese Journal of Clinical Rehabilitation
关键词
术中监护
面神经
桥脑小脑角肿瘤
术后康复
intraoperative monitoring
cerebellopontine tumors
triggered EMG
facial nerve
