Role of intraoperative neurophysiological monitoring during fluorescence-guided resection surgery

Pastor, Jesús; Vega-Zelaya, Lorena; Pulido, Paloma Contreras; Garnés-Camarena, Oscar; Abreu, Ângela Maria Mendes; Sola, Rafael G.

doi:10.1007/s00701-013-1864-0

Cited by 28 publications

(22 citation statements)

References 23 publications

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“…The settings for ECoG should consist of a bandwidth filter of 0.5-100 Hz, with the notch on, a gain of 750-1500 µV/div and a time base of 15-30 mm/s. As stated previously, some type of mathematical analysis can be helpful for the assessment of ECoG [5,6].…”

Section: Ecogmentioning

confidence: 99%

“…Stimulation is initiated at 4 mA and increased continuously in increments of 1-2 mA until a stable compound muscle action potential (CMAP) is recorded, at a minimum amplitude of 30 µV or until an upper limit of 30 mA is achieved without eliciting a CMAP [5,6].…”

Section: Direct Cortical Stimulation (Dcs)mentioning

confidence: 99%

“…Following the identification of functional areas via ECoG (Figure 1B), the location of the CS is determined by cSSEP phase reversal (Figure 1C). Accurate identification of the CS is extremely important because it permits identification of the PMC (Figure 1C) [5,6]. There is evidence that cSSEP phase reversal increases both the efficiency and the safety of PMC identification [50].…”

Section: Particularities Of Ionmmentioning

confidence: 99%

“…It is accepted that the primary criterion for monitoring MEP in the setting of supratentorial surgery is an amplitude reduction of >50%. Temporary motor deficits have been linked to reversible declines in MEP amplitude of >50%, whereas irreversible declines and losses in MEP are predictors of permanent motor deficits [5]. Pastor et al [5] described a study involving 34 patients who underwent surgical resection of glioma that was guided using 5-aminolevulinic acid (5-ALA) with no false-negative results.…”

Section: Continuous Ionm Techniquesmentioning

confidence: 99%

“…Advances in surgical techniques, such as intraoperative neurophysiological monitoring (IONM), intraoperative magnetic resonance imaging (MRI), diffusion tensor imaging (DTI), stereotactic guidance and fluorescent-guided resection (FGR), have facilitated the delineation of tumour borders and can aid in optimizing safe surgical resection [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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Intraoperative Neurophysiological Monitoring in Neuro-oncology

Vega-Zelaya¹,

Sola²,

Pastor³

2016

Neurooncology - Newer Developments

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Neurosurgery can be considered a radical method to treat some illnesses and can seriously damage the nervous system. To avoid deleterious effects, such injuries must be detected during their initial development by means of intraoperative neurophysiological techniques including intraoperative neurophysiological monitoring IONM and functional mapping .In this chapter, we review the most relevant and frequently performed IONM/mapping techniques. Some insight about the electrophysiological basis of stimulation and recording of the nervous system are provided. Intraoperative neurophysiological techniques can be divided into free running or evoked elicited. Among the first we discuss EMG, EEG and ECoG. Evoked potentials discussed include somato-sensory SSEPs , auditory BAEPs , visual VEPs , motor MEPs and stimulated EMG. We are especially interested in the clear and concise exposition of the methodological peculiarities, the fields of application and the flaws associated with the different techniques discussed, with a focus on practical applications. Therefore, we show examples of real operations performed at our institution.We conclude that IONM and mapping are some of the techniques with more relevance during recent decades for oncological neurosurgery. The widespread use and improvement of these techniques have allowed a safer removal of a radical tumour, reducing the risk of permanent postoperative deficits and better functional postsurgical outcomes during neuro-oncological surgery.

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Section: Ecogmentioning

confidence: 99%

Section: Direct Cortical Stimulation (Dcs)mentioning

confidence: 99%

Section: Particularities Of Ionmmentioning

confidence: 99%

Section: Continuous Ionm Techniquesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intraoperative Neurophysiological Monitoring in Neuro-oncology

Vega-Zelaya¹,

Sola²,

Pastor³

2016

Neurooncology - Newer Developments

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The role of 5‐aminolevulinic acid in enhancing surgery for high‐grade glioma, its current boundaries, and future perspectives: A systematic review

Mansouri

Mansouri²,

Hachem

et al. 2016

Cancer

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5-Aminolevulinic acid (5-ALA) has been approved as an intraoperative adjunct in glioma surgery in Europe, but not North America. A systematic review was conducted to assess the evidence regarding 5-ALA as a surgical adjunct. The MEDLINE, EMBASE, and CEN-TRAL databases were searched, using terms relevant to "5-ALA" and "high-grade gliomas." Included studies were based on adults aged 18 years who underwent surgical resection/biopsy. No language or date limitations were used. Forty-three studies (1830 patients) were identified. Thirty-six were coordinated by European countries, 2 were in the United States, and none were in Canada. One was randomized, 28 were prospective, and 14 were retrospective. Twenty-six studies assessed the utility of 5-ALA as a diagnostic tool, 24 assessed its influence on the extent of resection (EOR), 9 assessed survival, and 22 reported adverse events. 5-ALA had high sensitivity and positive predictive value, whereas its specificity increased with additional adjuncts. The EOR increased with 5-ALA, but only progression-free survival was significantly influenced. Reporting of adverse events was not systematic. The use of 5-ALA improved tumor visualization and thus enabled a greater EOR and perhaps increased survival. However, additional adjuncts may be necessary for maximizing the specificity of resection and patient safety. Additional parameters, such as patient quality of life and health economic analyses, would be informative. Thus, additional systematic collection of prospective evidence may be necessary for the global incorporation of this potentially valuable surgical adjunct into routine practice. Cancer 2016;122:2469-78.

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Methods and Principles of the Intraoperative Neurophysiologic Monitoring in Neurosurgery

Di Domenico,

Viola,

Izzo

et al. 2023

Acta Neurochirurgica Supplement

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Role of intraoperative neurophysiological monitoring during fluorescence-guided resection surgery

Abstract: IONM can be helpful during surgery to maximize the tumor resection, meanwhile help to avoid neurological deficits and, therefore, to improve the quality of life of these patients.

Cited by 28 publications

References 23 publications

Intraoperative Neurophysiological Monitoring in Neuro-oncology

Intraoperative Neurophysiological Monitoring in Neuro-oncology

The role of 5‐aminolevulinic acid in enhancing surgery for high‐grade glioma, its current boundaries, and future perspectives: A systematic review

Methods and Principles of the Intraoperative Neurophysiologic Monitoring in Neurosurgery

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