Monitoring Cortico-cortical Evoked Potentials Using Only Two 6-strand Strip Electrodes for Gliomas Extending to the Dominant Side of Frontal Operculum During One-step Tumor Removal Surgery
Monitoring Cortico-cortical Evoked Potentials Using Only Two 6-strand Strip Electrodes for Gliomas Extending to the Dominant Side of Frontal Operculum During One-step Tumor Removal Surgery
复制标题
仅使用两个 6 股带状电极监测一步肿瘤切除手术期间延伸至额盖优势侧的神经胶质瘤的皮质皮质诱发电位
DOI：
10.1016/j.wneu.2022.06.141
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Kawamata T
中科院分区：
文献类型：
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作者：
Saito T;Muragaki Y;Tamura M;Maruyama T;Nitta M;Tsuzuki S;Fukui A;Koriyama S;Kawamata T
手术切除延伸至额盖的胶质瘤优势侧有较高的严重语言功能障碍风险。在这里，我们报告记录皮质-皮质诱发电位（CCEP），仅使用两个6股带状电极监测术中语言相关的纤维。我们研究是否这个简单的程序是有用的，用于删除胶质瘤延伸到优势侧的额operculum.MethodsThis研究包括7例胶质瘤延伸到左额operculum。额叶语言区（弗拉）是在清醒开颅手术中首次通过功能映射确定的。接下来，将6股带状电极放置在弗拉上，而在颞侧，放置电极，以便平行于侧裂朝向后部语言区滑动。使用额侧电极进行电刺激，从颞侧电极测量CCEP。ResultsCCEP检测在所有情况下。术后即刻，所有患者均表现出不同程度的语言功能障碍。1例患者CCEP降至10%，24个月后恢复语言功能。1例CCEP轻微下降80%，另外5例CCEP无变化。这5例患者很快恢复语言功能在2周至1 month.ConclusionsThis研究证实了实用程序的CCEP监测只使用两个6股带状电极在一步手术。我们认为这种简单的方法有助于监测术中语言功能和预测其术后恢复的胶质瘤扩展到优势侧的额盖。
ObjectiveResection of the dominant side of gliomas extending to the frontal operculum has high risk of severe language dysfunction. Here, we report recording cortico-cortical evoked potentials (CCEP) using only two 6-strand strip electrodes to monitor language-related fibers intraoperatively. We examined whether this simple procedure is useful for removing gliomas extending to the dominant side of frontal operculum.MethodsThis study included 7 cases of glioma extending to the left frontal operculum. The frontal language area (FLA) was first identified by functional mapping during awake craniotomy. Next, a 6-strand strip electrode was placed on the FLA, while on the temporal side, an electrode was placed so as to slide parallel to the sylvian fissure toward the posterior language area. Electrical stimulation was performed using the electrode on the frontal side, and CCEPs were measured from the electrode on the temporal side.ResultsCCEPs were detected in all cases. Immediately after surgery, all patients demonstrated language dysfunction to varying degree. CCEP decreased to 10% in 1 patient, who recovered language function after 24 months. CCEP decreased slightly 80% in 1, and, in the 5 other cases, CCEPs did not change. These 5 patients soon recovered language function within 2 weeks to 1 month.ConclusionsThis study confirmed the utility of CCEP monitoring using only two 6-strand strip electrodes during one-step surgery. We believe this simple method helped in monitoring intraoperative language function and predicting its postoperative recovery in patients with gliomas extending to the dominant side of frontal operculum.