scholarly journals Electrophysiological Monitoring During Acoustic Neuroma and Other Posterior Fossa Surgery

1988 ◽  
Vol 15 (1) ◽  
pp. 73-81 ◽  
Author(s):  
R.D. Linden ◽  
C.H. Tator ◽  
C. Benedict ◽  
D. Charles ◽  
V. Mraz ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Real Time ◽  
Posterior Fossa ◽  
Acoustic Neuroma ◽  
Auditory Nerve ◽  
Cranial Nerves ◽  
Intracranial Stimulation ◽  
Electromyographic Activity ◽  
Posterior Fossa Surgery ◽  
Brainstem Response

ABSTRACT:Techniques used to monitor the function of the seventh and eighth cranial nerves during acoustic neuroma and other posterior fossa surgery are reviewed. The auditory brainstem response (ABR), electrocochleogram (ECochG) and direct recording from the auditory nerve (CNAP) were compared. The best technique is the ECochG, although in many cases, the CNAP should be used as a back-up technique. The CNAP is especially useful for the identification of the auditory nerve. Both can provide real-time feedback on the physiological integrity of the auditory nerve. The ABR may be helpful in monitoring brainstem function. For some procedures, optimal monitoring requires the combined recording of all three techniques.Monopolar constant-voltage intracranial stimulation of the facial nerve is helpful for the identification and preservation of the facial nerve. Audio monitoring of spontaneous electromyographic activity provides real-time feedback on the effect of surgical manipulation of the nerve. Monitoring of ephaptic transmission in the facial nerve during microvascular decompression for hemifacial spasm aids in the identification of the offending vessel.

Interest of Facial Nerve Monitoring in Posterior Fossa Surgery

2015 ◽  
pp. 1165-1168
Author(s):  
G. Rugiu ◽  
E. Yardeni ◽  
B. Fraysse ◽  
C. Berges
Keyword(s):  
Facial Nerve ◽  
Posterior Fossa ◽  
Posterior Fossa Surgery ◽  
Nerve Monitoring ◽  
Facial Nerve Monitoring

Facial reanimation with end-to-end hypoglossofacial anastomosis: 20 years’ experience

2009 ◽  
Vol 124 (1) ◽  
pp. 23-25 ◽  
Author(s):  
T Catli ◽  
Y A Bayazit ◽  
O Gokdogan ◽  
N Goksu
Keyword(s):  
Facial Nerve ◽  
Acoustic Neuroma ◽  
Cranial Nerves ◽  
Significant Difference ◽  
Facial Reanimation ◽  
Short And Long Term ◽  
End To End ◽  
Facial Function

AbstractObjective:This study aimed to evaluate retrospectively the results of experience with end-to-end anastomosis of cranial nerves VII and XII, performed due to transection of the facial nerve during acoustic neuroma removal.Methods:We assessed the facial reanimation results of 33 patients whose facial nerves had been transected during acoustic neuroma excision via a retrosigmoid approach, between 1985 and 2006, and who underwent end-to-end hypoglossofacial anastomosis. We compared the facial nerve functions of patients receiving short term (two to three years) and long term (more than three years) follow up, and we assessed any complications of the anastomosis.Results:A House–Brackmann grade III facial function was achieved in 46.2 and 86.4 per cent of the patients in the short and long term, respectively. House–Brackmann grade IV facial function was achieved in 53.8 and 13.6 per cent of the patients in the short and long term, respectively. There was a statistically significant difference between the facial recovery results, comparing the short and long term follow-up periods (p = 0.03). Disarticulation was the most common complication, seen in 19 (57.6 per cent) patients; numbness of the tongue was the next commonest (10 (30.3 per cent) patients). None of the patients developed dysphagia.Conclusion:Despite such morbidities as disarticulation and tongue numbness, end-to-end hypoglossofacial anastomosis is still an effective procedure for the surgical rehabilitation of static and dynamic facial nerve functions. Significant improvement in facial nerve function can occur more than three years post-operatively.

Facial Nerve Monitoring in Posterior Fossa Surgery

2013 ◽  
Vol 80 (6) ◽  
pp. e197-e198 ◽  
Author(s):  
Anil Nanda ◽  
Prashant Chittiboina
Keyword(s):  
Facial Nerve ◽  
Posterior Fossa ◽  
Posterior Fossa Surgery ◽  
Nerve Monitoring ◽  
Facial Nerve Monitoring

scholarly journals Intraoperative Facial Nerve Monitoring in Posterior Fossa Surgery: Prognostic Value

Skull Base ◽  
1993 ◽  
Vol 3 (04) ◽  
pp. 214-216 ◽  
Author(s):  
C. Berges ◽  
B. Fraysse ◽  
E. Yardeni ◽  
G. Rugiu
Keyword(s):  
Facial Nerve ◽  
Posterior Fossa ◽  
Prognostic Value ◽  
Posterior Fossa Surgery ◽  
Nerve Monitoring ◽  
Facial Nerve Monitoring

Mutism after posterior fossa surgery in children

1990 ◽  
Vol 72 (6) ◽  
pp. 959-963 ◽  
Author(s):  
Luigi Ferrante ◽  
Luciano Mastronardi ◽  
Michele Acqui ◽  
Aldo Fortuna
Keyword(s):  
Posterior Fossa ◽  
Fourth Ventricle ◽  
Cranial Nerves ◽  
Speech Disorder ◽  
Posterior Fossa Surgery ◽  
Content Type ◽  
Disturbance Of Consciousness ◽  
Lower Cranial Nerves ◽  
Fine Print

✓ Three patients aged 5½ to 9 years old with mutism after posterior fossa surgery are presented. The entity is discussed with a review of 15 additional previously reported cases in children aged 2 to 11 years. In all 18 patients, a large midline tumor of the posterior fossa (medulloblastoma in nine cases, astrocytoma in five, and ependymoma in four), often attached to one or both lateral recesses of the fourth ventricle, was removed. Mutism developed 18 to 72 hours after the operation (mean 41.5 hours) in patients with no disturbance of consciousness and no deficits of the lower cranial nerves or of the organs of phonation. All of these children had spoken in the first hours after surgery. The disorder lasted from 3 to 16 weeks (mean 7.9 weeks). Speech was regained after a period of dysarthria in six of the 10 cases for whom this information was available. The various hypotheses advanced to explain the pathogenesis of this speech disorder are analyzed.

Adjunctive Use of Endoscopy during Posterior Fossa Surgery to Treat Cranial Neuropathies

Neurosurgery ◽  
2001 ◽  
Vol 49 (1) ◽  
pp. 108-116 ◽  
Author(s):  
Wesley A. King ◽  
Phillip A. Wackym ◽  
Chandranath Sen ◽  
Glenn A. Meyer ◽  
John Shiau ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Microvascular Decompression ◽  
Cranial Nerves ◽  
Internal Auditory Canal ◽  
Vascular Compression ◽  
Posterior Fossa Surgery ◽  
Suboccipital Craniotomy ◽  
Neoplastic Processes ◽  
Rigid Endoscope ◽  
Cranial Neuropathies

Abstract OBJECTIVE The objective of this study was to determine the utility and safety of rigid endoscopy as an adjunct during posterior fossa surgery to treat cranial neuropathies. METHODS A suboccipital craniotomy was performed for 19 patients with non-neoplastic processes involving the Vth, VIIth, and/or VIIIth cranial nerves. Ten patients with trigeminal neuralgia (n = 8), hemifacial spasm (n = 1), or intractable tinnitus (n = 1) underwent primarily microvascular decompression procedures. One patient with geniculate neuralgia underwent nervus intermedius sectioning combined with microvascular decompression. Eight patients underwent unilateral vestibular nerve neurectomies for treatment of Ménière's disease. A 0- or 30-degree rigid endoscope was used in conjunction with the standard microscopic approach for all procedures. RESULTS All patients experienced resolution or significant improvement of their preoperative symptoms after posterior fossa surgery. The endoscope allowed improved definition of anatomic neurovascular relationships without the need for significant cerebellar or brainstem retraction. Cleavage planes between the cochlear and vestibular nerves entering the internal auditory canal and sites of vascular compression could not be microscopically observed for several patients; however, endoscopic identification was possible for all patients. There were no complications related to the use of the endoscope. CONCLUSION The rigid endoscope can be used safely during posterior fossa surgery to treat cranial neuropathies, and it allows improved observation of the cranial nerves, nerve cleavage planes, and vascular anatomic features without significant cerebellar or brainstem retraction.

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