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23.02.2018 | Clinical Study

The utility of “low current” stimulation threshold of intraoperative electromyography monitoring in predicting facial nerve function outcome after vestibular schwannoma surgery: a prospective cohort study of 103 large tumors

verfasst von: Xiang Huang, Junwei Ren, Jian Xu, Ming Xu, Danqi Chen, Mingyu Chen, Kaiyuan Ji, Hai Wang, Huiyu Chen, Lijie Cao, Yilin Shao, Ping Zhong, Richard Ballena, Liangfu Zhou, Ying Mao

Erschienen in: Journal of Neuro-Oncology | Ausgabe 2/2018

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Abstract

To investigate the predictive utility of stimulation threshold (ST) of intraoperative electromyography monitoring for facial nerve (FN) outcomes among vestibular schwannoma (VS) patients postoperatively. The authors enrolled 103 unilateral VS patients who underwent surgical resection into a prospective cohort observational study from January 2013 to April 2015 in our hospital. ST values were used to categorize 81 patients into the “low current” (ST ≤ 0.05 mA) group and 22 patients into the control (ST > 0.05 mA) group. The FN function outcomes were summarized and correlated with these two groups at 1, 3, 6, and 12 months after surgery. Binary regression analysis revealed that the percentage of “good” FN outcome, defined by House-Brackmann (HB) classification of facial function (I–II), in the “low current” group was significantly higher than that of the control group (42.0 vs. 4.5% at 1 month, P = 0.015; 64.2 vs. 31.8% at 3 months, P = 0.024; 72.8 vs. 40.9% at 6 months, P = 0.021; 84.0 vs. 45.5% at 12 months, P = 0.002). Ordinal regression analysis showed that the distribution of HB scores was shifted in a favorable direction in the “low current” group at 1, 3, 6, and 12 months postoperatively. For patients with HB IV at the first month postoperative period, the recovery rate of the “low current” group was significantly higher than that of control group (P = 0.003). “Low current” can predict FN function outcomes better and has faster recovery rates than that of the control group.

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Titel: The utility of “low current” stimulation threshold of intraoperative electromyography monitoring in predicting facial nerve function outcome after vestibular schwannoma surgery: a prospective cohort study of 103 large tumors
verfasst von: Xiang Huang
Junwei Ren
Jian Xu
Ming Xu
Danqi Chen
Mingyu Chen
Kaiyuan Ji
Hai Wang
Huiyu Chen
Lijie Cao
Yilin Shao
Ping Zhong
Richard Ballena
Liangfu Zhou
Ying Mao
Publikationsdatum: 23.02.2018
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology / Ausgabe 2/2018
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-018-2806-8

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The utility of “low current” stimulation threshold of intraoperative electromyography monitoring in predicting facial nerve function outcome after vestibular schwannoma surgery: a prospective cohort study of 103 large tumors

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