Evaluation of the Predictive Value of Intraoperative Changes in Motor-Evoked Potentials of Caudal Cranial Nerves for the Postoperative Functional Outcome

Marcel Kullmann, Marcos Tatagiba, Marina Liebsch, Guenther C. Feigl

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Objective The predictive value of changes in intraoperatively acquired motor-evoked potentials (MEPs) of the lower cranial nerves (LCN) IX-X (glossopharyngeal-vagus nerve) and CN XII (hypoglossal nerve) on operative outcomes was investigated. Methods MEPs of CN IX-X and CN XII were recorded intraoperatively in 63 patients undergoing surgery of the posterior cranial fossa. We correlated the changes of the MEPs with postoperative nerve function. Results For CN IX-X, we found a correlation between the amplitude of the MEP ratio and uvula deviation (P = 0.028) and the amplitude duration of the MEP and gag reflex function (P = 0.027). Patients with an MEP ratio of the glossopharyngeal-vagus amplitude ≤1.47 μV had a 3.4 times increased risk of developing a uvula deviation. Patients with a final MEP duration of the CN IX-X ≤11.6 milliseconds had a 3.6 times increased risk for their gag reflex to become extinct. Conclusions Our study greatly contributes to the current knowledge of intraoperative MEPs as a predictor for postoperative cranial nerve function. We were able to extent previous findings on MEP values of the facial nerve on postoperative nerve function to 3 additional cranial nerves. Finding reliable predictors for postoperative nerve function is of great importance to the overall quality of life for a patient undergoing surgery of the posterior cranial fossa.

Original languageEnglish (US)
Pages (from-to)329-334
Number of pages6
JournalWorld neurosurgery
Volume95
DOIs
StatePublished - Nov 1 2016

Keywords

  • Glossopharyngeal-vagus nerve
  • Hypoglossal nerve
  • Intraoperative neuromonitoring
  • Motor-evoked potentials
  • Posterior fossa tumors
  • Postoperative nerve function

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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