지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2013.1
- 수록면
- 244 - 251 (8page)
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초록· 키워드
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Background and Purpose Intraoperative neurophysiological monitoring (IONM) using upper and lower somatosensory evoked potentials (SSEPs) is an established technique used to predict and prevent neurologic injury during intracranial tumor resections. Endoscopic port surgery (EPS) is a minimally-invasive approach to deep intraparenchymal and intraventricular brain tumors. The authors intended to evaluate the predictive value of SSEP monitoring during resection of intracranial brain tumors using a parallel endoscopic technique.
Methods A retrospective review was conducted of patients operated on from 2007-2010 utilizing IONM in whom endoscopic ports were used to remove either intraparenchymal or intraventricular tumors. Cases were eligible for review if an endoscopic port was used to resect an intracranial tumor and the electronic chart included all intraoperative monitoring data as well as pre- and post-operative neurologic exams.
Results 139 EPS cases met criteria for inclusion. Eighty five patients (61%) had intraparenchymal and fifty four (39%) had intraventricular tumors or colloid cysts. SSEP changes were seen in eleven cases (7.9%), being irreversible in three (2.2%) and reversible in eight cases (5.8%). Seven patients (5.0%) with intraparenchymal tumors had SSEP changes which met our criterea for significant changes while there were four (2.9%) with intraventricular (p-value=0.25). Five patients suffered post operative deficits, two reversible and two irreversible SSEP changes. Only one case exhibited post operative hemiparesis with no SSEP changes. The positive predictive value of SSEP was 45.4% and the negative predictive value was 99.2%.
Conclusions Based on the high negative and low positive predictive values, the utility of SSEP monitoring for cylindrical port resections may be limited. However, the use of SSEP monitoring can be helpful in reducing the impact of endoscopic port manipulation when the tumor is closer to the somatosensory pathway.
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참고문헌 (21)
참고문헌 신청
Bejjani GK / 1998 / The predictive value of intraoperative somatosensory evoked potential monitoring: review of 244 procedures / Neurosurgery 43 : 491 ~ 498
Bradshaw K / 1984 / Clinical evaluation of spinal cord monitoring in scoliosis surgery / Spine (Phila Pa 1976) 9 : 636 ~ 643
Brown RH / 1984 / Cortical evoked potential monitoring. A system for intraoperative monitoring of spinal cord function / Spine (Phila Pa 1976) 9 : 256 ~ 261
Chung I / 2009 / Upper-limb somatosensory evoked potential monitoring in lumbosacral spine surgery: a prognostic marker for position-related ulnar nerve injury / The Spine J
De Vleeschauwer P / 1988 / Monitoring of somatosensory evoked potentials in carotid surgery: results, usefulness and limitations of the method / Annals of Vascular Surgery 2
Bradshaw K / 1984 / Clinical evaluation of spinal cord monitoring in scoliosis surgery / Spine (Phila Pa 1976) 9 : 636 ~ 643
Brown RH / 1984 / Cortical evoked potential monitoring. A system for intraoperative monitoring of spinal cord function / Spine (Phila Pa 1976) 9 : 256 ~ 261
Chung I / 2009 / Upper-limb somatosensory evoked potential monitoring in lumbosacral spine surgery: a prognostic marker for position-related ulnar nerve injury / The Spine J
De Vleeschauwer P / 1988 / Monitoring of somatosensory evoked potentials in carotid surgery: results, usefulness and limitations of the method / Annals of Vascular Surgery 2
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