Efficacy of the visual evoked potential monitoring in endoscopic transnasal transsphenoidal surgery as a real-time visual function

2018 ◽  
Vol 66 (4) ◽  
pp. 1075 ◽  
Author(s):  
Daisuke Wajima ◽  
Fumihiko Nishimura ◽  
Young-Soo Park ◽  
Yasushi Motoyama ◽  
Ichiro Nakagawa ◽  
...  
Keyword(s):  
Real Time ◽  
Visual Function ◽  
Transsphenoidal Surgery ◽  
Visual Evoked Potential ◽  
Evoked Potential ◽  
Evoked Potential Monitoring ◽  
Visual Evoked ◽  
Potential Monitoring

Intraoperative Monitoring of the Visual Evoked Potential during Endoscopic Sinus Surgery

1994 ◽  
Vol 111 (5) ◽  
pp. 575-579 ◽  
Author(s):  
Garrett D. Herzon ◽  
David L. Zealear
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Visual Evoked Potential ◽  
Evoked Potential ◽  
Cold Water ◽  
Light Emitting Diode ◽  
Sinus Surgery ◽  
Visual Response ◽  
Evoked Potential Monitoring ◽  
Visual Evoked ◽  
Potential Monitoring

Iatrogenic blindness resulting from conventional and endoscopic sinus surgery continues to be a major concern to the head and neck surgeon. A new electrophysiologic monitoring technique has been developed that can help avoid damage to the optic nerve and visual system. The approach involves monitoring the visual evoked potential with presentation of flash stimuli to the eyes. Thirty patients with chronic sinusitis underwent endoscopic sinus surgery with visual evoked potential monitoring. The procedures were carried out with patients under intravenous general anesthesia. Needle cortical electrodes were placed in the scalp. A modified light-emitting diode array/goggle was positioned in front of the patient's closed eyes. A triggered flash of 2 Hz was delivered through the goggle to stimulate the patient's retina. Cortical responses were amplified and averaged for 100 trials. Amplitude and peak-latency changes were monitored to alert the surgeon to any change in the visual response during the surgical dissection. Although no changes in response were noted during dissection, cold-water irrigation and reflected telescopic light could produce variations in the recorded responses, as will be discussed. Visual evoked potential monitoring may prevent a surgeon from continuing a bilateral procedure when there is indication of iatrogenic visual loss from dissection on the first side. Visual evoked potential also reassures the operator that no damage has occurred to the visual pathway at the conclusion of a case. Methods, case selection, operative technique, and documentation of monitoring will be discussed.

scholarly journals Reliability of Intraoperative Visual Evoked Potential Monitoring during Neurosurgery

2016 ◽  
Vol 36 (2) ◽  
pp. 141-146
Author(s):  
Yuka AKASAKI ◽  
Hironobu HAYASHI ◽  
Tsunenori TAKATANI ◽  
Fumihiko NISHIMURA ◽  
Hiroyuki NAKASE ◽  
...  
Keyword(s):  
Visual Evoked Potential ◽  
Evoked Potential ◽  
Evoked Potential Monitoring ◽  
Visual Evoked ◽  
Potential Monitoring

Comparison Between Conventional Flash and Off-Response Intraoperative Visual Evoked Potential Monitoring for Endoscopic Endonasal Surgery

2021 ◽  
Author(s):  
Ridzky Firmansyah Hardian ◽  
Toshihiro Ogiwara ◽  
Atsushi Sato ◽  
Yu Fujii ◽  
Yota Suzuki ◽  
...  
Keyword(s):  
Visual Function ◽  
Predictive Value ◽  
Visual Evoked Potential ◽  
Evoked Potential ◽  
Light Stimulus ◽  
Warning Signal ◽  
Endoscopic Endonasal ◽  
Evoked Potential Monitoring ◽  
Flash Stimulation ◽  
Visual Evoked

Abstract BACKGROUND Intraoperative flash stimulation visual evoked potential (VEP) monitoring has been used for endoscopic endonasal approach (EEA). Recently, off-response VEP, which is recorded when the light stimulus is turned off, was introduced to monitor visual function intraoperatively. OBJECTIVE To evaluate off-response VEP monitoring in comparison with the conventional flash stimulation VEP monitoring for EEA. METHODS From March 2015 to March 2020, 70 EEA surgeries with intraoperative VEP monitoring (140 eyes) were performed. Light stimuli were delivered by a pair of goggle electrodes. Recording electrodes were placed on the scalp over the occipital region. The warning signal was prompted by a reduction of the peak-to-peak amplitude of the VEP by more than 50% compared to the initial amplitude. Visual function was assessed pre- and postoperatively. Results of flash and off-response VEP monitoring were compared. RESULTS VEP was recorded in 134 eyes. Warning signal occurred in 23 eyes (transient in 17 eyes and permanent in 6 eyes). Two eyes showed permanent VEP attenuation for flash VEP monitoring, in which one patient had postoperative visual function deterioration. Four eyes showed permanent VEP attenuation for off-response VEP monitoring, where 2 patients had postoperative visual function deterioration. Sensitivity, specificity, positive predictive value, and negative predictive value were 100%, 98.9%, 50%, and 100%, respectively, for flash stimulation VEP, and 100%, 97.8%, 50%, and 100%, respectively, for off-response VEP. CONCLUSION VEP monitoring was useful to monitor visual function in EEA surgery. Off-response VEP monitoring was not inferior to conventional flash stimulation VEP monitoring.

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