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Intraoperative monitoring

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https://www.readbyqxmd.com/read/29776768/-topical-anesthesia-without-the-use-of-an-anesthesiologist-in-adult-outpatient-cataract-surgery-assessment-of-selection-criteria-on-consultation-report-of-248-cases
#1
M Pepin, E Rineau, A Caignard, S Leruez, P Gohier
INTRODUCTION: This work aims to evaluate selection criteria used during the cataract surgery scheduling visit, to choose whether or not there will be an anesthesiologist available during the surgery, depending upon the patient's comorbidities. MATERIALS AND METHODS: Retrospective study performed in 2016 in Angers university medical center. Two groups were established on the cataract surgery scheduling visit, based on patients' comorbidities and vital signs (blood pressure, heart rate)...
May 15, 2018: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/29774175/motor-interconnections-between-superior-and-inferior-laryngeal-nerves
#2
Emin Gurleyik
Introduction Anatomical studies on human cadavers have established anastomoses between laryngeal nerves. However, we need to functionally identify motor communication via these anastomoses between the recurrent laryngeal nerve (RLN) and the external branch of the superior laryngeal nerve (EBSLN) in living bodies. We aim to establish motor interconnections using intraoperative nerve monitoring (IONM). Methods IONM of 112 EBSLNs and RLNs in 62 thyroidectomy cases was used to establish motor functions of laryngeal nerves...
March 16, 2018: Curēus
https://www.readbyqxmd.com/read/29773852/protective-effects-of-intraoperative-nerve-monitoring-ionm-for-recurrent-laryngeal-nerve-injury-in-thyroidectomy-meta-analysis
#3
Binglong Bai, Wuzhen Chen
Recurrent laryngeal nerve (RLN) injury is an intractable complication of thyroidectomy. Intraoperative nerve monitoring (IONM) was designed to prevent RLN injury. However, the results concerning the protective effect of IONM on RLN injury are still controversial. We searched all eligible databases from 1980 to 2017. Meta-analysis was performed to evaluate the effect of IONM on RLN injury. Sensitivity analysis was also conducted to check the stability of our results. There were 34 studies included in the analysis...
May 17, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29772562/using-neuroimaging-to-uncover-awareness-in-brain-injured-and-anesthetized-patients
#4
Mackenzie Graham, Adrian M Owen, Charles Weijer, Lorina Naci
We cast a novel perspective on two distinct populations: patients who become accidentally intraoperatively aware after receiving general anesthesia and severely brain-injured patients who are diagnosed as being in a vegetative state. In both cases, patients are behaviorally non-responsive -and on this basis presumed to lack consciousness- yet, retain covert awareness. In both contexts, detecting consciousness is highly challenging, yet highly important for ensuring adequate patient care. Although great strides have been made in the development of depth-of-anesthesia monitors, these monitors have significant limitations...
June 1, 2018: Frontiers in Bioscience (Scholar Edition)
https://www.readbyqxmd.com/read/29772366/giant-cell-ependymoma-of-cervical-medullary-junction-a-case-report-of-a-long-term-survivor-and-review-of-literature
#5
REVIEW
Martina Cappelletti, Andrea G Ruggeri, Giorgia Iacopino, Roberto Delfini
Ependymoma accounts for 3-9% of all neuroepithelial tumors. The giant cell ependymoma is a rare and distinct variant, of which only twenty-two cases have been described in literature. Starting from 2007, the WHO acknowledged this rare subtype. The cytological features of GCE are the presence of pleomorphic giant cells with several cellular atypias, which at intra-operative frozen diagnosis may appear to be high-grade glial lesions. Despite its apparently malignant histology, GCE seems to be a neoplasm with a relatively good prognosis...
May 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29767477/effect-of-neurological-monitoring-in-postoperative-5-15-days-residual-thyroidectomy-after-primary-thyroid-cancer-surgery
#6
Miao-Yun Long, Fei-Yu Diao, Li-Na Peng, Lang-Ping Tan, Yue Zhu, Kai Huang, Hong-Hao Li
AIM: To explore the application of intraoperative neurological monitoring in residual thyroidectomy 5-15 days after thyroid cancer operation and the influence on postoperative serum thyroglobulin (Tg), recurrent laryngeal nerve and function of parathyroid glands. METHODS: Material of patients receiving thyroid surgery from January 2010 to December 2016 was retrospectively analyzed. Cases meeting with standards were enrolled for analysis and the patients were divided into neurological monitoring group and non-neurological monitoring group in line with the use of neurological monitoring during the operation...
May 16, 2018: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29765890/intraoperative-monitoring-of-hypoglossal-nerve-using-hypoglossal-motor-evoked-potential-in-infratentorial-tumor-surgery-a-report-of-two-cases
#7
Seung Yeun Kim, Hyo Won Im, Young-Doo Choi, Keewon Kim, Jin Wook Kim, Yong Hwy Kim, Han Gil Seo
The hypoglossal nerve (CN XII) may be placed at risk during posterior fossa surgeries. The use of intraoperative monitoring (IOM), including the utilization of spontaneous and triggered electromyography (EMG), from tongue muscles innervated by CN XII has been used to reduce these risks. However, there were few reports regarding the intraoperative transcranial motor evoked potential (MEP) of hypoglossal nerve from the tongue muscles. For this reason, we report here two cases of intraoperative hypoglossal MEP monitoring in brain surgery as an indicator of hypoglossal deficits...
April 2018: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29756691/cerebrovascular-autoregulation-impairments-during-cardiac-surgery-with-cardiopulmonary-bypass-are-related-to-postoperative-cognitive-deterioration-prospective-observational-study
#8
Birute Kumpaitiene, Milda Svagzdiene, Edmundas Sirvinskas, Virginija Adomaitiene, Vytautas Petkus, Rolandas Zakelis, Solventa Krakauskaite, Romanas Chomskis, Arminas Ragauskas, Teodoro F Dagi, Rimantas Benetis
BACKGROUND: Post-operative cognitive dysfunction (POCD) occurs in approximately 33-83% of patients after cardiac surgery with cardiopulmonary bypass (CPB). Recent clinical data suggest that real-time, intraoperative monitoring of patient- specific cerebrovascular autoregulation (CA) may help to prevent POCD by detecting individual critical limits for mean arterial pressure (MAP) outside which CA is impaired. Objectives of the study were to detect the episodes of impaired CA during cardiac surgery with CPB, and to investigate the association between CA impairment and POCD...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29753078/isolated-pediatric-intramedullary-schwannoma-case-report-and-review-of-the-literature
#9
Alessandro Landi, Giovanni Grasso, Fabrizio Gregori, Giorgia Iacopino, Andrea Ruggeri, Roberto Delfini
BACKGROUND: Intramedullary (IM) schwannomas are rare entities representing the 0.3-1% of intramedullary tumors and 1.1% of spinal schwannomas. Beside many theories proposed, their rare occurrence might be related to the absence of Schwann cells into the spinal cord. Pediatric IM schwannomas are uncommon and in absence of neurofibromatosis (NF) they are extremely rare. To date, very few cases have been reported in the literature. CASE DESCRIPTION: We describe the case of a 8 year-old female affected by a progressive paraparesis...
May 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29752218/elevated-international-normalized-ratio-is-not-associated-with-increased-perioperative-morbidity-in-podiatric-limb-salvage-surgery-a-retrospective-analysis
#10
Nalini Vadivelu, Alice M Kai, Feng Dai, Hosni Mikhael, Rima Aouad, Peter Blume
The risk of hemorrhage always exists in anticoagulated patients with an elevated international normalized ratio (INR), a risk that must be measured against the necessity for surgical procedures. The objective of the present retrospective medical record study was to assess the safety with which limb salvage procedures can be conducted in patients with an INR >1.4. The medical records of 231 patients who had undergone limb salvage procedures by 1 surgeon at the Yale New Haven Health System from November 2008 through July 2014 were reviewed...
May 8, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29750694/impact-of-2-distinct-levels-of-mean-arterial-pressure-on-near-infrared-spectroscopy-during-cardiac-surgery-secondary-outcome-from-a-randomized-clinical-trial
#11
Frederik Holmgaard, Anne G Vedel, Theis Lange, Jens C Nilsson, Hanne B Ravn
BACKGROUND: Near-infrared spectroscopy (NIRS) is used worldwide to monitor regional cerebral oxygenation (rScO2) during cardiopulmonary bypass (CPB). Intervention protocols meant to mitigate cerebral desaturation advocate to increase mean arterial pressure (MAP) when cerebral desaturation occurs. However, the isolated effect of MAP on rScO2 is uncertain. The aim of the present study was in a randomized, blinded design to elucidate the effect of 2 distinct levels of MAP on rScO2 values during CPB...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29746219/feasibility-of-continuous-intraoperative-neural-monitoring-during-transoral-endoscopic-thyroidectomy-vestibular-approach-in-a-porcine-model
#12
Daqi Zhang, Shijie Li, Gianlorenzo Dionigi, Tie Wang, Jiao Zhang, Gaofeng Xue, Hui Sun
BACKGROUND: Experimental study to evaluate feasibility of continuous intraoperative neural monitoring (C-IONM) in transoral endoscopic thyroidectomy vestibular approach (TOETVA). METHODS: Duroc-Landrace pigs were orally intubated with electromyogram endotracheal tube. Automatic periodic stimulation (APS) electrode was allocated in the operative field through the 5-mm ports. APS was then repose on vagal nerve (VN) with different approaches: (1) median, that is, between sternothyroid and thyroid gland; and (2) lateral, that is, between sternocleidomastoid and sternothyroid...
May 10, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29745130/intraoperative-hyperspectral-determination-of-human-tissue-properties
#13
Eric Larry Wisotzky, Florian Cornelius Uecker, Philipp Arens, Steffen Dommerich, Anna Hilsmann, Peter Eisert
We address the automatic differentiation of human tissue using multispectral imaging with promising potential for automatic visualization during surgery. Currently, tissue types have to be continuously differentiated based on the surgeon's knowledge only. Further, automatic methods based on optical in vivo properties of human tissue do not yet exist, as these properties have not been sufficiently examined. To overcome this, we developed a hyperspectral camera setup to monitor the different optical behavior of tissue types in vivo...
May 2018: Journal of Biomedical Optics
https://www.readbyqxmd.com/read/29742889/intraoperative-neurophysiological-monitoring-a-review-of-techniques-used-for-brain-tumor-surgery-in-children
#14
REVIEW
Keewon Kim, Charles Cho, Moon-Suk Bang, Hyung-Ik Shin, Ji-Hoon Phi, Seung-Ki Kim
Intraoperative monitoring (IOM) utilizes electrophysiological techniques as a surrogate test and evaluation of nervous function while a patient is under general anesthesia. They are increasingly used for procedures, both surgical and endovascular, to avoid injury during an operation, examine neurological tissue to guide the surgery, or to test electrophysiological function to allow for more complete resection or corrections. The application of IOM during pediatric brain tumor resections encompasses a unique set of technical issues...
May 2018: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29740508/case-presentation-and-short-perspective-on-management-of-foraminal-far-lateral-discs-and-stenosis
#15
REVIEW
Nancy E Epstein
Background: The management of lumbar foraminal/far lateral discs (FOR/FLD) with stenosis remains controversial. Operative choices should be based on each patient's preoperative dynamic X-ray findings, magnetic resonance (MR), and computed tomography (CT) studies. Here we reviewed several options for decompression alone vs. decompression with fusion. Methods: Safe excision of FOR/FLD with stenosis should begin at the level above the disc herniation, as identification of the superior, foraminally, and far laterally exiting nerve root is critical...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29739535/do-we-feel-pain-during-anesthesia-a-critical-review-on-surgery-evoked-circulatory-changes-and-pain-perception
#16
REVIEW
A Cividjian, F Petitjeans, N Liu, M Ghignone, M de Kock, L Quintin
The difficulty of defining the three so-called components of « an-esthesia » is emphasized: hypnosis, absence of movement, and adequacy of anti-nociception (intraoperative « analgesia »). Data obtained from anesthetized animals or humans delineate the activation of cardiac and vasomotor sympathetic reflex (somato-sympathetic reflex) and the cardiac parasympathetic deactivation observed following somatic stimuli. Sympathetic activation and parasympathetic deactivation are used as monitors to address the adequacy of intraoperative anti-nociception...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29738385/safe-intraoperative-neurophysiologic-monitoring-during-posterior-spinal-fusion-in-a-patient-with-cochlear-implants
#17
Godwin Abiola, Bryan Kevin Ward, Stephen Bowditch, Eva Katharina Ritzl, John Patrick Carey
OBJECTIVE: Cochlear implants are generally considered a contraindication for any procedure requiring electrical stimulation near the implant. We present a case of a patient undergoing intraoperative transcranial electrical motor-evoked potential monitoring with a cochlear implant without adverse outcomes. PATIENT: A 12-year-old girl with a history of VACTERL presented with worsening congenital kyphosis and bilateral severe-to-profound hearing loss. Since age 7 the patient used a cochlear implant in the right ear and hearing aid in the left ear...
June 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29736882/a-challenging-case-of-tumor-induced-osteomalacia-pathophysiological-and-clinical-implications
#18
Luciano Colangelo, Cristiana Cipriani, Jessica Pepe, Alessandro Corsi, Chiara Sonato, Giulia Follacchio, Mirella Cilli, Walter Gianni, Federica Ferrone, Oreste Moreschini, Lorraine A Fitzpatrick, Salvatore Minisola
We investigated the usefulness of fibroblast growth factor 23 (FGF23) intraoperative assay to monitor tumor resection in patients with oncogenic osteomalacia. A 33-year-old man with 5 years' history of lumbar and pelvis pain together with multiple vertebral fractures was admitted to our hospital. He was diagnosed with ankylosing spondylitis 1 year before. Laboratory investigation showed low tubular reabsorption of phosphate (0.41 mmol/L) despite chronic hypophosphatemia (0.39/L). Increased plasma values of FGF23 (673 pg/mL; n...
May 7, 2018: Calcified Tissue International
https://www.readbyqxmd.com/read/29733992/neuronavigation-guided-corticospinal-tract-mapping-in-brainstem-tumor-surgery-better-preservation-of-motor-function
#19
Zhibao Li, Mingran Wang, Liwei Zhang, Xing Fan, Xiaorong Tao, Lei Qi, Miao Ling, Xiong Xiao, Yuliang Wu, Dongze Guo, Hui Qiao
BACKGROUND: A new method in brainstem surgery, neuronavigation (NN)-guided corticospinal tract (CST) mapping, was used in a retrospective study of patients undergoing brainstem tumor surgery. METHODS: We studied 40 patients with a brainstem tumor who were enrolled in this study. Patients whose worst preoperative muscle strength of the four limbs was greater than three levels from normal on the Lovett scale were divided into two groups: a treatment group of 21 patients that included NN-guided CST mapping and routine intraoperative neurophysiology monitoring (IONM), and a control group of 19 patients that included routine NN and routine IONM...
May 4, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29733410/perioperative-multimodal-evaluation-and-surgical-tactics-of-tumor-related-epilepsy-2-dimensional-operative-video
#20
Chengxin Ma, Rui Feng, N U Farrukh Hameed, Jie Zhang, Dongxiao Zhuang, Jinsong Wu
Treatment of tumor-related epilepsy (TRE), especially for tumors near critical areas, requires surgeons to strike a balance between the epileptic benefit and functional outcome after surgery. Here, we present a case in which multimodal evaluation facilitated the achievement of such surgical balance. Informed patient consent was obtained. A 17-yr-old female presented with seizure attacks for 2 yr. Magnetic resonance imaging (MRI) revealed a right parietal mass lesion with hypointense signal on T1W imaging, hyperintense signal on T2W imaging, and homogeneous enhancement...
May 4, 2018: Operative Neurosurgery (Hagerstown, Md.)
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