Intraoperative Neurophysiological Monitoring: Our Experience

• Published in: Journal of Neurological Surgery Part A: Central European Neurosurgery
• Main Authors: Karan, Vedrana, Horvat, I., Karan, M., Papić, V., Đilvesi, Đ, Vuleković, P.
• Format: Conference Proceeding
• Language: English
• Published: 19.10.2015
• ISSN: 2193-6315; 2193-6323
• DOI: 10.1055/s-0035-1566379

Introduction Intraoperative neurophysiological monitoring (IONM) is a method which uses different kinds of electrophysiological methods to monitor the function of neural structures during the operation. The methods are motor evoked potentials (MEP), somatosensory evoked potentials (SSEP), brainstem auditory evoked potentials (BAEP), visual evoked potentials (VEP), electroencephalography (EEG), and electromyography (EMG). There are a large number of indications for using IONM in neurosurgery, as well as in other fields of surgery. Aim Our aim was to evaluate use of IONM at Clinic for Neurosurgery, Clinical Center of Vojvodina. Materials and Methods Our first experience with IONM was in 2009 when we performed craniotomy on an awake patient to remove eloquent region brain tumor. After that we used IONM occasionally until 1 January 2015 when its use became routine in everyday practice at Clinic for Neurosurgery, Clinical Center of Vojvodina. Among other things, we have done six speech mapping procedures on awake patients, tumors of cerebellopontine angle, spinal cord tumors, and supratentorial brain tumors. Results By using IONM, we were able to remove tumors and preserve the function of very important structures such as eloquent cortex, cranial nerves, corticospinal tract, dorsal columns medial lemniscus system, and motor and somatosensory cortex. Conclusion IONM allows monitoring and mapping of appropriate structures that enable identification, monitoring of function, safer approach, and in large number of cases more radical excision of tumor with preserving function. Keywords intraoperative neurophysiological monitoring