Direct cochlear nerve stimulation monitoring through evoked muscle responses during retrosigmoid vestibular schwannoma resection surgery: technical note.

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Serval ID
serval:BIB_E8ED9B5DD01B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Direct cochlear nerve stimulation monitoring through evoked muscle responses during retrosigmoid vestibular schwannoma resection surgery: technical note.
Journal
Journal of neurosurgery
Author(s)
Starnoni D., Cossu G., Maduri R., Tuleasca C., George M., Maire R., Messerer M., Levivier M., Pralong E., Daniel R.T.
ISSN
1933-0693 (Electronic)
ISSN-L
0022-3085
Publication state
In Press
Peer-reviewed
Oui
Pages
1-6
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
Cochlear nerve preservation during surgery for vestibular schwannoma (VS) may be challenging. Brainstem auditory evoked potentials and cochlear compound nerve action potentials have clearly shown their limitations in surgeries for large VSs. In this paper, the authors report their preliminary results after direct electrical intraoperative cochlear nerve stimulation and recording of the postauricular muscle response (PAMR) during resection of large VSs.
The details for the electrode setup, stimulation, and recording parameters are provided. Data of patients for whom PAMR was recorded during surgery were prospectively collected and analyzed.
PAMRs were recorded in all patients at the ipsilateral vertex-earlobe scalp electrode, and in 90% of the patients they were also observed in the contralateral electrode. The optimal stimulation intensity was found to be 1 mA at 1 Hz, with a good cochlear response and an absent response from other nerves. At that intensity, the ipsilateral cochlear response had an initial peak at a mean (± SEM) latency of 11.6 ± 1.5 msec with an average amplitude of 14.4 ± 5.4 µV. One patient experienced a significant improvement in his audition, while that of the other patients remained stable.
PAMR monitoring may be useful in mapping the position and trajectory of the cochlear nerve to enable hearing preservation during surgery.
Keywords
cochlear nerve, hearing preservation, intraoperative neuromonitoring, stimulation, surgery, surgical technique, vestibular schwannoma
Pubmed
Create date
16/08/2022 13:39
Last modification date
31/12/2022 7:15
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