Intraoperative recording of laryngeal adductor reflex and cortical motor evoked potentials during jugular foramen schwannoma surgery: a case report and literature review.
J Clin Monit Comput
; 36(6): 1585-1590, 2022 12.
Article
em En
| MEDLINE
| ID: mdl-35763166
ABSTRACT
PURPOSE:
Schwannoma, a tumor originating from the peripheral nervous system, may arise from the vagus nerve, although it is not very often. Injury of the vagus nerve by surgical attempts may have consequences that will seriously affect the patient's quality of life. In recent years, continuous monitoring of the laryngeal adductor reflex (LAR) has become a promising methodology for evaluating vagus nerve function intraoperatively. We refer to our experience changing our surgical strategy due to concurrent deterioration in LAR and CoMEPs intraoperatively. We also provide a literature review and summarize the current knowledge of this technique.METHODS:
The LAR was elicited and recorded by an electromyographic endotracheal tube in a 36-year-old man diagnosed with vagal nerve schwannoma. Subdermal needle electrodes were placed in both cricothyroid (CTHY) muscles for corticobulbar motor evoked potentials (CoMEPs) recording.RESULTS:
Recordings of ipsilateral LAR and CTHY CoMEPs were obtained despite preoperative ipsilateral cord vocalis weakness. The surgical strategy was altered after the simultaneous decrease of CTHY CoMEPs and LAR amplitudes, and the surgery was completed with subtotal resection. No additional neurological deficit was observed in the patient except dysphonia, which resolved within a few weeks after the surgery.CONCLUSIONS:
We conclude that LAR with vagal nerve CoMEPs are two complementary methods and provide reliable information about the functional status of the vagus nerve during surgery.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Forâmen Jugular
/
Neurilemoma
Tipo de estudo:
Systematic_reviews
Aspecto:
Patient_preference
Limite:
Adult
/
Humans
/
Male
Idioma:
En
Revista:
J Clin Monit Comput
Assunto da revista:
INFORMATICA MEDICA
/
MEDICINA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Turquia