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Intraoperative monitoring

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https://www.readbyqxmd.com/read/29334639/vestibular-schwannoma-and-hearing-preservation-usefulness-of-level-specific-ce-chirp-abr-monitoring-a-retrospective-study-on-25-cases-with-preoperative-socially-useful-hearing
#1
Luciano Mastronardi, Ettore Di Scipio, Guglielmo Cacciotti, Raffaelino Roperto
BACKGROUND AND OBJECTIVES: Decision-making regarding the therapy of vestibular schwannoma (VS) changed over the last decades, during which curative microsurgery has been promoted. Goals of VS microsurgery are: extensive resection, facial nerve (FN) preservation and, in selected cases, hearing preservation (HP). The aim of this study is to evaluate postoperative HP with reference to tumor size in patients operated on with Level Specific (LS)-CE-Chirp® ABR monitoring. PATIENTS AND METHODS: Twentyfive consecutive patients with socially useful hearing (SUH) underwent VS microneurosurgery by retrosigmoid (RS) approach...
January 10, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29330874/safety-of-high-current-stimulation-for-intermittent-intraoperative-neural-monitoring-in-thyroid-surgery-a-porcine-model
#2
I-Cheng Lu, Pi-Ying Chang, Gregory W Randolph, Hsiu-Ya Chen, Kuang-Yi Tseng, Yi-Chu Lin, Feng-Yu Chiang, Che-Wei Wu
OBJECTIVES: During monitored thyroidectomy, displacement of the recurrent laryngeal nerve (RLN) or vagus nerve (VN) in some complicated cases can increase the risk of injury. Although increasing the stimulus current can facilitate nerve mapping and localization, the safety of a high-current stimulus remains unknown. Therefore, this study evaluated the safety of a high-current stimulus in a porcine model. METHODS: Short-duration (1 minute), high-current (3, 5, 10, 15, 20, 25, and 30 mA at 4Hz) stimulus pulses were repeatedly applied to the RLN or VN in six anesthetized piglets...
January 13, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29330639/changes-in-tissue-and-cerebral-oxygenation-following-spinal-anesthesia-in-infants-a-prospective-study
#3
Alexander B Froyshteter, Dmitry Tumin, Emmett E Whitaker, David P Martin, Mumin Hakim, Hina Walia, Tarun Bhalla, Joseph D Tobias
Use of spinal anesthesia (SA) in children may address concerns about potential neurocognitive effects of general anesthesia. We used near-infrared spectroscopy (NIRS) to assess the effects of SA on cerebral and tissue oxygenation in 19 patients aged 7 ± 3 months. Prior to SA placement, NIRS monitors were placed on the forehead (cerebral) and the thigh (tissue). Intraoperative cerebral and tissue saturation were 73 ± 7 and 80 ± 11%, respectively, before SA placement. NIRS measurements were monitored every minute for 30 min after SA placement and modeled using mixed-effects linear regression...
January 12, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29325471/intracranial-subarachnoid-hemorrhage-following-cervical-laminoplasty-a-report-of-two-cases
#4
Yuichi Kondo, Kazunari Fushimi, Makoto Takasawa, Shigeo Kanamori, Takaki Miyagawa, Kenji Kawashima, Kazutoshi Yokoyama, Haruhiko Akiyama
Intracranial hemorrhage is a rare complication of spinal surgery. Case 1 was a 58-year-old man who underwent cervical laminoplasty. No apparent iatrogenic dural rupture or cerebrospinal fluid leakage was observed. An hour after the surgery, the patient had convulsions and became restless thereafter. CT revealed an intracranial SAH. The patient recovered normal consciousness the next morning. Case 2 was a 68-year-old woman who underwent cervical laminoplasty without postoperative CSF leakage. Six days after the surgery, the patient continued to complain of nausea and headache...
January 12, 2018: International Journal of Neuroscience
https://www.readbyqxmd.com/read/29319622/a-high-portal-venous-pressure-gradient-increases-gut-related-bacteremia-and-consequent-early-mortality-after-living-donor-liver-transplantation
#5
Siyuan Yao, Shintaro Yagi, Ryuji Uozumi, Taku Iida, Miki Nagao, Yusuke Okamura, Takayuki Anazawa, Hideaki Okajima, Toshimi Kaido, Shinji Uemoto
BACKGROUND: Portal hypertension (PHT) is defined as a portal venous pressure gradient (PVPG) exceeding 5 mmHg, which results in severe clinical manifestations. However, the validity of intraoperative PVPG monitoring and the association between PHT and bacterial translocation (BT) after liver transplantation remain unclear. METHODS: In this retrospective study, 223 patients who underwent primary adult-to-adult living donor liver transplantation (ALDLT) from 2008 to 2015 were divided into 2 groups based on the PVPG at the end of the operation: high PVPG (>5 mmHg, n=69) and low PVPG (≤5 mmHg, n=154)...
January 10, 2018: Transplantation
https://www.readbyqxmd.com/read/29319013/intraoperative-cardiovascular-response-of-natural-orifice-transluminal-endoscopic-surgery-versus-laparoscopy-a-comparative-animal-study
#6
Stefan Patrascu, Catalin Andu Copaescu, Valeriu Surlin, Sandu Ramboiu, Alice Nicoleta Dragoescu, Sorin Stanilescu, Dan Cristian, Bogdan Silviu Ungureanu, Daniela Elena Burtea, Ana Maria Patrascu, Florin Turcu, Adrian Saftoiu
BACKGROUND: Natural orifice transluminal endoscopic surgery (NOTES) emerged as a new alternative method in minimally invasive techniques. Although a very small number of studies have compared the physiologic response in NOTES to laparoscopy, the results remain controversial. AIM: This experimental animal study aims to evaluate the intraoperative cardiovascular and respiratory effects of pure transluminal natural orifice surgery and conventional laparoscopy. MATERIALS AND METHODS: Twenty female pigs (Sus scrofa domesticus) equally divided into two study groups were assigned to either pure natural orifice transluminal endoscopic techniques (Group 1) or conventional laparoscopic surgery (Group 2) and monitored intraoperatively in terms of heart rate (HR), systolic blood pressure (SBP) and O2saturation (SpO2) for 1 h...
January 10, 2018: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29318355/an-enhanced-recovery-after-surgery-eras-protocol-for-ambulatory-anorectal-surgery-reduced-postoperative-pain-and-unplanned-returns-to-care-after-discharge
#7
Aaron B Parrish, Sean M O'Neill, Steven R Crain, Tara A Russell, Deepak K Sonthalia, Vu T Nguyen, Armen Aboulian
BACKGROUND: Ambulatory surgery for anorectal procedures has been proven to be safe and effective. Specific perioperative pathways combining multiple interventions have been shown to optimize recovery and outcomes associated with inpatient colorectal surgery. However, there are no major studies describing and evaluating a standardized protocol for ambulatory anorectal surgery. The purpose of this study was to evaluate the outcomes of a modified enhanced recovery after surgery (ERAS) protocol for ambulatory anorectal surgery...
January 9, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29317969/pulse-pressure-analysis-to-guide-intraoperative-phlebotomy-prior-to-cardiac-surgery
#8
Brian Schloss, Dmitry Tumin, Aymen Naguib, Julie Rice, Mark Galantowicz, Joseph D Tobias
Background: The aim of this study was to evaluate the response of the LiDCO-rapid™ during intraoperative phlebotomy in anesthetized children prior to surgery for congenital heart disease. Methods: After the induction of general anesthesia and endotracheal intubation, baseline vital signs were recorded, along with pulse pressure variability (PPV) and stroke volume variability (SVV) from the LiDCO-rapid™ and cerebral oxygenation (rSO2) using near-infrared spectroscopy (NIRS)...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29315450/facial-nerve-schwannoma-a-case-report-radiological-features-and-literature-review
#9
Giulia Pilloni, Barbara Massa Mico, Roberto Altieri, Francesco Zenga, Alessandro Ducati, Diego Garbossa, Fulvio Tartara
Facial nerve schwannoma localized in the middle fossa is a rare lesion. We report a case of a facial nerve schwannoma in a 30-year-old male presenting with facial nerve palsy. Magnetic resonance imaging (MRI) showed a 3 cm diameter tumor of the right middle fossa. The tumor was removed using a sub-temporal approach. Intraoperative monitoring allowed for identification of the facial nerve, so it was not damaged during the surgical excision. Neurological clinical examination at discharge demonstrated moderate facial nerve improvement (Grade III House-Brackmann)...
December 22, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29313181/intraoperative-neurophysiological-monitoring-during-spinal-surgery-technical-review-in-open-and-minimally-invasive-approaches
#10
REVIEW
Fabio Cofano, Francesco Zenga, Marco Mammi, Roberto Altieri, Nicola Marengo, Marco Ajello, Paolo Pacca, Antonio Melcarne, Carola Junemann, Alessandro Ducati, Diego Garbossa
Neurophysiological monitoring is of undoubted value for the intraoperative safety of neurosurgical procedures. Widely developed and used for cranial surgery, it is equally as effective, though perhaps less commonly employed, for spinal pathology. The most frequently used techniques for intraoperative monitoring during spinal surgery include somatosensory evoked potentials (SSEPs), motor evoked potentials (MEPs) and electromyography, which can either be spontaneous free-running (sEMG) or triggered (tEMG). The knowledge of the benefits and limitations of each modality is essential in optimising the value of intraoperative monitoring during spinal procedures...
January 8, 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29310828/-sedation-using-dexmedetomidine-and-remifentanil-with-local-anesthesia-for-intraoperative-speech-monitoring-a-case-report
#11
Leonardo Riedi de Andrade, Yara Marcondes Machado Castiglia
BACKGROUND AND OBJECTIVE: Some surgical procedures such as laryngoplasty require patients to remain conscious during the intraoperative phase in order to enable speech monitoring. Dexmedetomidine and remifentanil were used in this study, since they promote appropriate patient collaboration with facilitated awakening, and are rapidly eliminated. CASE REPORT: The patient complained of dysphonia, which had resulted from unilateral vocal fold paralysis after previous thyroidectomy...
January 5, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29309977/usefulness-and-stability-of-intraoperative-digital-subtraction-angiography-using-the-trans-radial-route-in-arteriovenous-malformation-surgery
#12
Won Ki Yoon, Hoon Kim, Young Woo Kim, Seong Rim Kim, Ik Seong Park
OBJECTIVE: Digital subtraction angiography (DSA) is the gold standard to confirm complete removal of an AVM nidus. However, the trans-femoral approach requires specialized instrumentation and is cumbersome and difficult to perform with the patient in the prone or decubitus position. The authors report the use of intraoperative DSA (iDSA) with the trans-radial approach and examine its usefulness and safety. MATERIAL AND METHODS: We retrospectively reviewed clinical features, radiologic images, surgical findings, and iDSA findings of AVM patients who underwent nidus removal surgery...
January 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29309641/congress-of-neurological-surgeons-systematic-review-and-evidence-based-guidelines-on-intraoperative-cranial-nerve-monitoring-in-vestibular-schwannoma-surgery
#13
Esther X Vivas, Matthew L Carlson, Brian A Neff, Neil T Shepard, D Jay McCracken, Alex D Sweeney, Jeffrey J Olson
Question 1: Does intraoperative facial nerve monitoring during vestibular schwannoma surgery lead to better long-term facial nerve function? Target Population: This recommendation applies to adult patients undergoing vestibular schwannoma surgery regardless of tumor characteristics. Recommendation: Level 3: It is recommended that intraoperative facial nerve monitoring be routinely utilized during vestibular schwannoma surgery to improve long-term facial nerve function...
December 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29305914/the-comparison-of-monitoring-of-cerebral-blood-flow-by-c-flow-and-transcranial-doppler-in-carotid-endarterectomy
#14
Xu Wang, Bin Yang, Yan Ma, Peng Gao, Yabing Wang, Yanfei Chen, Liqun Jiao, Feng Ling, Guoguang Zhao
OBJECTIVE: To prospectively compare the use of the c-FLOW (cerebral blood flow monitor) and transcranial Doppler (TCD) as two techniques for assessing brain perfusion during carotid endarterectomy (CEA). METHODS: This was a prospective, single center, observational study. All patients were monitored using c-FLOW and TCD during the operation. Changes from baseline values of cerebral blood flow index (CFI) and blood flow velocity of middle cerebral artery (V-MCA) were recorded following carotid artery clamping and unclamping...
January 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29302786/intraoperative-changes-in-corneal-structure-during-excimer-laser-phototherapeutic-keratectomy-ptk-assessed-by-intraoperative-optical-coherence-tomography
#15
Sebastian Siebelmann, Jens Horstmann, Paula Scholz, Björn Bachmann, Mario Matthaei, Manuel Hermann, Claus Cursiefen
PURPOSE: Excimer laser phototherapeutic keratectomy (PTK) is a safe treatment for superficial corneal opacities, e.g., in corneal dystrophies or degenerations. Nevertheless, no standardized treatment protocols are available and intraoperative monitoring was not possible, so far. Here we evaluate the potential benefits of the intraoperative assessment by microscope-integrated intraoperative optical coherence tomography (MI-OCT) of corneal optical properties during PTK. METHODS: Retrospective study of eight patients (one male, seven females; age range, 43-80 years, mean = 66...
January 4, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/29301602/progress-in-intraoperative-neurophysiological-monitoring-for-the-surgical-treatment-of-thoracic-spinal-stenosis
#16
Yong-Sheng Liu, Yu Zhao
Thoracic spinal stenosis (TSS) is a group of clinical syndromes caused by thoracic spinal cord compression, which always results in severe clinical complications. The incidence of TSS is relatively low compared with lumbar spinal stenosis, while the incidence of spinal cord injury during thoracic decompression is relatively high. The reported incidence of neurological deficits after thoracic decompression reached 13.9%. Intraoperative neurophysiological monitoring (IONM) can timely provide information regarding the function status of the spinal cord, and help surgeons with appropriate performance during operation...
December 30, 2017: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/29301040/where-and-when-to-cut-fluorescein-guidance-for-brain-stem-and-spinal-cord-tumor-surgery-technical-note
#17
Eric Suero Molina, Walter Stummer
BACKGROUND: Spinal cord and brain stem lesions require a judicious approach with an optimized trajectory due to a clustering of functions on their surfaces. Intraoperative mapping helps locate function. To confidently locate such lesions, neuronavigation alone lacks the desired accuracy and is of limited use in the spinal cord. OBJECTIVE: To evaluate the clinical value of fluoresceins for initial delineation of such critically located lesions. METHODS: We evaluated fluorescein guidance in the surgical resection of lesions with blood-brain barrier disruption demonstrating contrast enhancement in magnet resonance imaging in the spinal cord and in the brain stem in 3 different patients...
December 29, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29300715/intraoperative-somatosensory-evoked-potential-monitoring-decreases-eeg-burst-suppression-ratio-during-deep-general-anesthesia-erratum
#18
(no author information available yet)
No abstract text is available yet for this article.
January 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/29300714/electrophysiology-of-olfactory-and-optic-nerve-in-outpatient-and-intraoperative-settings
#19
Praveen Hariharan, Jeffery R Balzer, Katherine Anetakis, Donald J Crammond, Parthasarathy D Thirumala
Evoked potentials are time-locked electrophysiologic potentials recorded in response to standardized stimuli using scalp electrodes. These responses provide good temporal resolution and have been used in various clinical and intraoperative settings. Olfactory evoked potentials (OEPs) may be used as an adjunct tool in identifying patients of Parkinson disease and Alzheimer dementia. In clinical practice, visual evoked potentials (VEPs) are particularly useful in identifying subclinical cases of optic neuritis and in treatment surveillance...
January 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/29298706/minimally-invasive-versus-open-pancreatoduodenectomy-leopard-2-study-protocol-for-a-randomized-controlled-trial
#20
Thijs de Rooij, Jony van Hilst, Koop Bosscha, Marcel G Dijkgraaf, Michael F Gerhards, Bas Groot Koerkamp, Jeroen Hagendoorn, Ignace H de Hingh, Tom M Karsten, Daan J Lips, Misha D Luyer, I Quintus Molenaar, Hjalmar C van Santvoort, T C Khé Tran, Olivier R Busch, Sebastiaan Festen, Marc G Besselink
BACKGROUND: Data from observational studies suggest that minimally invasive pancreatoduodenectomy (MIPD) is superior to open pancreatoduodenectomy regarding intraoperative blood loss, postoperative morbidity, and length of hospital stay, without increasing total costs. However, several case-matched studies failed to demonstrate superiority of MIPD, and large registry studies from the USA even suggested increased mortality for MIPDs performed in low-volume (<10 MIPDs annually) centers...
January 3, 2018: Trials
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