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J Neurol Surg B Skull Base 2012; 73(05): 308-315
DOI: 10.1055/s-0032-1321507
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Intraoperative Transcranial Motor-Evoked Potential Monitoring of the Facial Nerve during Cerebellopontine Angle Tumor Resection

Maura K. Cosetti
1   Departments of Otolaryngology, New York University School of Medicine, New York, New York, United States
,
Ming Xu
2   Departments of Neurosurgery, New York University School of Medicine, New York, New York, United States
,
Andrew Rivera
1   Departments of Otolaryngology, New York University School of Medicine, New York, New York, United States
,
Daniel Jethanamest
1   Departments of Otolaryngology, New York University School of Medicine, New York, New York, United States
,
Maggie A. Kuhn
1   Departments of Otolaryngology, New York University School of Medicine, New York, New York, United States
,
Aleksandar Beric
2   Departments of Neurosurgery, New York University School of Medicine, New York, New York, United States
3   Departments of Neurology and Orthopedic Surgery, New York University School of Medicine, New York, New York, United States
,
John G. Golfinos
2   Departments of Neurosurgery, New York University School of Medicine, New York, New York, United States
,
J. Thomas Roland
1   Departments of Otolaryngology, New York University School of Medicine, New York, New York, United States
2   Departments of Neurosurgery, New York University School of Medicine, New York, New York, United States
› Author Affiliations
Further Information

Publication History

20 September 2011

28 March 2012

Publication Date:
30 July 2012 (online)

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Abstract

Objective To determine whether transcranial motor-evoked potential (TCMEP) monitoring of the facial nerve (FN) during cerebellopontine angle (CPA) tumor resection can predict both immediate and long-term postoperative FN function.

Design Retrospective review.

Setting Tertiary referral center.

Main Outcome Measures DeltaTCMEP (final-initial) and immediate and long-term facial nerve function using House Brackmann (HB) rating scale.

Results Intraoperative TCMEP data and immediate and follow-up FN outcome are reported for 52 patients undergoing CPA tumor resection. Patients with unsatisfactory facial outcome (HB >2) at follow-up had an average deltaTCMEP of 57 V, whereas those with HB I or II had a mean deltaTCMEP of 0.04 V (t = -2.6, p < 0.05.) Intraoperative deltaTCMEP did not differ significantly between groups with satisfactory (HB I, II) and unsatisfactory (HB > 2) facial function in the immediate postoperative period.

Conclusion Intraoperative TCMEP of the facial nerve can be a valuable adjunct to conventional facial nerve electromyography during resection of tumors at the CPA. Intraoperative deltaTCMEP >57 V may be worrisome for long-term recovery of satisfactory facial nerve function.

Keywords

facial nerve - cerebellopontine angle - intraoperative electrophysiologic monitoring - transcranial motor-evoked potential
 

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