경피적 바늘 삽입법을 이용한 수술 중 외안뇌신경 감시의 유용성: 증례

Abstract

Intraoperative neurophysiologic monitoring (INM) is effective method to prevent operation-related nerve damage in various kinds of neurosurgery. In skull base surgery, there is a possibility of iatrogenic damage to extraocular cranial nerves (EOCNs), which can be prevented with proper INM. We report a case with chondroma involving clivus and compressing pons who had intraoperative EOCN monitoring using the percutaneous needle insertion method during extended endoscopic transsphenoidal approach for the resection of the tumor. During the tumor removal, the structure suspected of being the right abducens nerve was exposed, and it was confirmed that electromyography activity was generated from the lateral rectus muscle by applying electrical stimulation to this structure. Postoperatively, the patient had no diplopia. Our case supports that intraoperative EOCN monitoring using the percutaneous needle insertion could be useful for the assessment of EOCN function during skull base surgery.