IONM in Cranial Surgery: Difference between revisions
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==Introduction== | ==Introduction== | ||
Procedures and the cranial nerves we monitor | |||
1. Thyroidectomy. : vagus nerve (CN X), recurrent laryngeal nerve is one of approximately 11 branches of CN X. | |||
Parotidectomy, tympanoplasty, mastoidectomy, microvascular decompression: facial nerve (CN VII). CNVII branches include the temporal, zygomatic, buccal, marginal mandibular, cervical. | |||
Microvascular decompression: glossopharyngeal (CN IX) | |||
Acoustic neuroma resection: glossopharyngeal (CN IX) and hypoglossal (CN XII) | |||
Acoustic neuroma resection is a neurosurgical procedure where the brainstem and multiple cranial nerves (CN) are at risk for injury. This includes not only the vestibulocochlear (CN VIII) and facial (CN VII) nerves, but in large tumors the lower cranial nerves as well, including glossopharyngeal, vagus, accessory and hypoglossal (CN IX–XII respectively). | |||
==Cortical mapping== | ==Cortical mapping== | ||
Revision as of 02:49, 2 March 2020
Introduction
Procedures and the cranial nerves we monitor 1. Thyroidectomy. : vagus nerve (CN X), recurrent laryngeal nerve is one of approximately 11 branches of CN X. Parotidectomy, tympanoplasty, mastoidectomy, microvascular decompression: facial nerve (CN VII). CNVII branches include the temporal, zygomatic, buccal, marginal mandibular, cervical. Microvascular decompression: glossopharyngeal (CN IX) Acoustic neuroma resection: glossopharyngeal (CN IX) and hypoglossal (CN XII)
Acoustic neuroma resection is a neurosurgical procedure where the brainstem and multiple cranial nerves (CN) are at risk for injury. This includes not only the vestibulocochlear (CN VIII) and facial (CN VII) nerves, but in large tumors the lower cranial nerves as well, including glossopharyngeal, vagus, accessory and hypoglossal (CN IX–XII respectively).
Cortical mapping
Skull base or CP angle tumors
Deep brain stimulation
Intracranial vascular procedures
Neurovascular information
The brain is very sensitive to changes in blood flow. Cerebral blood flow is maintained and regulated by a homeostatic process called autoregulation. Cerebral blood flow is maintained at approximately 40-70 ml per minute for every 100 g of brain tissue, which occurs over a wide range of arterial blood pressures (~60 - 160 mm Hg) in a healthy brain. To maintain constant cerebral blood flow, several homeostatic mechanisms converge to maintain a balance between vasoconstriction and vasodilation, which includes myogenic, neurogenic, metabolic, and endothelial components (Armstead, Anesthesiol Clin. 2016; 34(3): 465–477).