Scientific analysis of surgical procedures by new neurophysiological monitoring that visualize neural function

• Project/Area Number: 24592154
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Cerebral neurosurgery
• Research Institution: The University of Tokyo
• Principal Investigator: NAKATOMI Hirofumi 東京大学, 医学部附属病院, 准教授 (10420209)
• Co-Investigator(Kenkyū-buntansha): SAITO Nobuhito 東京大学, 医学部附属病院, 教授 (60262002)
• Project Period (FY): 2012-04-01 – 2015-03-31
• Project Status: Completed (Fiscal Year 2014)
• Budget Amount: ¥5,330,000 (Direct Cost: ¥4,100,000、Indirect Cost: ¥1,230,000); Fiscal Year 2014: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000); Fiscal Year 2013: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000); Fiscal Year 2012: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
• Keywords: 神経機能温存 / 神経機能モニタリング / 聴神経腫瘍 / 神経機能 / 持続モニタリング / 手術科学 / 持続神経機能モニタリング / 見える化

Outline of Final Research Achievements

Improving preservation of function during the acoustic neuroma surgery is still the big issue. We have invented the following two new intraoperative neurophysiological monitoring that visualize real time neural function during the operation and applied to acoustic neuroma surgery. The first is dorsal cochlear nucleus action potential (AEDNAP) monitoring for cochlear nerve (CN). The other is root exit zone-elicited compound muscle action potential (FREMAP) monitoring for facial nerve (FN). We have applied these monitoring to over 170 acoustic neuroma cases. Ultimately we have found that both final AEDNAP amplitude preservation ratio (APR) and final FREMAP APR were associated with same-grade functional preservation. The threshold for these functional preservation of the final AEDNAP APR and final FREMAP APR were 36.5% and 61.5% respectively. We think we have developed the new surgical system that convinces the surgeons with postoperative neural function of patients during the surgery.

Research Products

• [Journal Article] Improved preservation of function during acoustic neuroma surgery. (2015)
  • Author(s): Nakatomi H, Miyazaki H, Tanaka M, Kin T, Yoshino M, Oyama H, Usui M, Moriyama H, Kojima H, Kaga K, Saito N
  • Journal Title: J Neurosurg Volume: 122 Pages: 24-33
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Diffusion tensor tractography of normal facial and vestibulocochlear nerves (2015)
  • Author(s): Yoshino M, Kin T, Ito A, Saito T, Nakagawa D, Kamada K, Mori H, Kunimatsu A, Nakatomi H, Oyama H, Saito N
  • Journal Title: Int J Comput Assist Radiol Surg Volume: 10 Issue: 4 Pages: 383
  • DOI: 10.1007/s11548-014-1129-2
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Feasibility of diffusion tensor tractography for preoperative prediction of the location of the facial and vestibulocochlear nerves in relation to vestibular schwannoma (2015)
  • Author(s): Yoshino M, Kin T, Ito A, Saito T, Nakagawa D, Ino K, Kamada K, Mori H, Kunimatsu A, Nakatomi H, Oyama H, Saito N
  • Journal Title: Acta Neurochir (Wien) Volume: Apr 12
  • Peer Reviewed / Acknowledgement Compliant
• [Presentation] How to use new cochlear nerve monitoring and revised facial nerve monitoring (2015)
  • Author(s): Hidemi Miyazaki and Hirofumi Nakatomi
  • Organizer: Acoustic neuroma meeting 2015
  • Place of Presentation: Shanghai, China
  • Year and Date: 2015-04-13 – 2015-04-15
  • Invited
• [Presentation] Facial nerve root elicited muscle action potential monitoring (2015)
  • Author(s): Hirofumi Nakatomi
  • Organizer: Acoustic neuroma meeting 2015
  • Place of Presentation: Shanghai, China
  • Year and Date: 2015-04-13 – 2015-04-15
  • Invited
• [Presentation] Intraoperative decision making regarding facial nerve preservation, focusing on the different monitoring modalities and their importance (2015)
  • Author(s): Hirofumi Nakatomi
  • Organizer: Acoustic neuroma meeting 2015
  • Place of Presentation: Shanghai, China
  • Year and Date: 2015-04-13 – 2015-04-15
  • Invited
• [Presentation] 神経機能を“見える化”する新たな術中モニタリングを用いた聴神経腫瘍の手術科学（シンポジウム） (2013)
  • Author(s): 中冨浩文、宮崎日出海、田中実、金太一、吉野正紀、齋藤延人
  • Organizer: 第72回脳神経外科学会総会.
  • Place of Presentation: 横浜
• [Presentation] Improving functional preservation in acoustic neuroma surgery. (2013)
  • Author(s): Hirofumi Nakatomi, Nobuhito Saito
  • Organizer: AANS/CNS 10th Biennial Satellite Tumor Symposium. New Orleans.
  • Place of Presentation: New Orleans
• [Presentation] 神経機能を“見える化”する新たな術中モニタリングを用いた聴神経腫瘍の手術科学. (2013)
  • Author(s): 中冨浩文、宮崎日出海、田中実、金太一、吉野正紀、齋藤延人.
  • Organizer: 第22回聴神経腫瘍研究会.東京 2013.6.8
  • Place of Presentation: 東京
• [Presentation] 小脳橋角部大型血管芽腫手術に於けるハイリスク栄養血管の“解剖と神経機能の見える化”によるファンクショナルプリザーベーション (シンポジウム) (2013)
  • Author(s): 中冨浩文、金太一、吉野正紀、中川大地、庄島正明、斉藤延人.
  • Organizer: 第18回日本脳腫瘍の外科学会、大津2013.9.19-9.20
  • Place of Presentation: 大津
• [Presentation] Unclippable脳動脈瘤手術に於けるハイリスク穿通枝の“解剖と神経機能の見える化”によるファンクショナルプリザーベーション (口演) (2013)
  • Author(s): 中冨浩文、金太一、吉野正紀、中川大地、庄島正明、斉藤延人.
  • Organizer: 第25回脳循環代謝学会、札幌 2013.11.1-11.2
  • Place of Presentation: 札幌
• [Presentation] 神経機能を“見える化”する新たな術中モニタリングを用いた聴神経腫瘍の手術科学 (2012)
  • Author(s): 中冨浩文
  • Organizer: 2012年度、脳神経外科学会総会
  • Place of Presentation: 大阪
• [Patent(Industrial Property Rights)] New US Patent (2014)
  • Inventor(s): Hirofumi Nakatomi
  • Industrial Property Rights Holder: Hirofumi Nakatomi
  • Industrial Property Rights Type: 特許
  • Filing Date: 2014-12-18
  • Acquisition Date: 2015-01-21
  • Overseas
• [Patent(Industrial Property Rights)] US patent (2013)
  • Inventor(s): Hirofumi Nakatomi
  • Industrial Property Rights Holder: Hirofumi Nakatomi
  • Industrial Property Rights Type: 特許
  • Filing Date: 2013-09-01
  • Overseas