Bite injuries caused by transcranial electrical stimulation motor-evoked potentials' monitoring: incidence, associated factors, and clinical course
Bite injuries caused by transcranial electrical stimulation motor-evoked potentials' monitoring: incidence, associated factors, and clinical course
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DOI：
10.1007/s00540-018-2562-0
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发表时间：
2018-12-01
影响因子：
2.8
通讯作者：
Kawaguchi, Masahiko
中科院分区：
文献类型：
--
作者：
Yata, Sachiko;Ida, Mitsuru;Kawaguchi, Masahiko
目的经颅电刺激运动诱发电位监测引起的咬伤发生率为0.13%~0.19%。然而，在临床实践中，咬伤似乎比以前报道的更频繁。目的探讨经颅电刺激运动诱发电位监测所致咬伤的发生率及围手术期危险因素。方法选择2017年6月至2017年12月在日本某三级医院接受经颅电刺激运动诱发电位监测的择期手术患者。所有患者均由口腔外科医生在手术前和术后进行评估。结果186例患者中有12例发生咬合损伤，其中唇部3例，口腔粘膜6例，舌部4例。无一例需要缝合修补。12例中11例术后病程平稳，术后12天内痊愈。1例有舌部溃疡和血肿，口腔进食困难，持续进食困难。患者在经颅电刺激运动诱发电位监测中运动剧烈与咬合损伤有关(p=0.03)。结论在经颅电刺激运动诱发电位监测中，口腔外科医生评估咬合损伤的发生率为6.5%，监测期间运动剧烈的患者易发生咬合损伤。在极少数情况下，经颅电刺激运动诱发电位监测可能会导致口腔摄取困难和味觉障碍。
PurposeThe incidence of bite injuries associated with transcranial electrical stimulation motor-evoked potentials monitoring reportedly ranges from 0.13 to 0.19%. However, in clinical practice, bite injuries appear to occur more frequently than previously reported. Our aim was to identify the incidence of and perioperative risk factors associated with bite injuries caused by transcranial electrical stimulation motor-evoked potential monitoring.MethodsPatients who underwent elective surgery with transcranial electrical stimulation motor-evoked potential monitoring at a single tertiary hospital in Japan between June 2017 and December 2017 were included in this study. All patients were assessed by oral surgeons preoperatively and postoperatively. The associated factors with bite injuries were explored by the univariate analysis.Results12 of 186 patients experienced 13 bite injuries, including three lip, six oral mucosa, and four tongue injuries. No patient required suture repair. 11 of 12 patients had uneventful postoperative courses and were cured within 12 postoperative days. One patient with a tongue ulcer and a hematoma had difficulty in oral intake and persistent dysgeusia. Patient severe movement during transcranial electrical stimulation motor-evoked potential monitoring was associated with bite injuries (p=0.03).ConclusionsThe incidence of bite injuries assessed by oral surgeons was 6.5% in patients with transcranial electrical stimulation motor-evoked potential monitoring, and the patients with severe movement during the monitoring tended to incur bite injuries. In rare cases, transcranial electrical stimulation motor-evoked potential monitoring may cause difficulty in oral intake and dysgeusia.