Improving functional preservation by visualizing neural function in neurosurgery

2017 Fiscal Year Final Research Report

• Project/Area Number: 15K10354
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: 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): 齊藤 延人 東京大学, 医学部附属病院, 教授 (60262002)
• Project Period (FY): 2015-04-01 – 2018-03-31
• Keywords: 聴神経腫瘍 / 小脳橋角部髄膜腫 / 顔面神経機能温存 / 蝸牛神経機能温存 / 持続モニタリング / 振幅温存率 / 術中待機治療

Outline of Final Research Achievements

Intraoperative cochlear nerve (CN) and facial nerve (FN) functions were evaluated using continuous auditory-evoked dorsal cochlear nucleus action potential (AEDNAP) and FN root exit zone-elicited compound muscle action potential (FREMAP) monitoring during acoustic neuroma (AN) surgery in 210 patients and CPA meningioma (MGM) surgery in 40 patients. Logistic regression revealed that final AEDNAP amplitude preservation ratio (APR) more than 36.5% and & more than 28.5% predicted same grade CN preservation in ANs and in MGMs respectively. It also showed that final oris muscle FREMAP APR more than 58.5% and more than 52.5% predicted same grade FN preservation in ANs and in MGMs respectively. Our thresholds for AEDNAP APR and FREMAP APR provided indicators of when the neurosurgeon should pause the surgical procedure. Extended recuperation treatment seemed effective after ultrasonic injury of the FN and could help to restore nerve damage, especially after traction injury of the CN.

Free Research Field

頭蓋底外科、神経機能温存