Intraoperative recording of trigeminal evoked potentials during orthognathic surgery.
Intraoperative recording of trigeminal evoked potentials during orthognathic surgery.
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正颌手术期间三叉神经诱发电位的术中记录。
DOI：
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发表时间：
1990
期刊：
影响因子：
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通讯作者：
Wolford Lm
中科院分区：
文献类型：
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作者：
Jones Dl;Wolford Lm
在常见的颌面外科手术矢状劈开截骨术中，三叉神经的下牙槽支处于危险之中。 The purpose of this study was to evaluate the use of somatosensory evoked potentials to assess the functional state of the nerve during surgery. Ten patients scheduled for bilateral sagittal split osteotomies were studied.将记录电极放置在头顶和枕骨上方的头皮上，并将皮下刺激电极插入颏孔上方，间隔 1 cm。 Recordings were made bilaterally from all patients.基线记录是在麻醉诱导后、初次切口之前进行的。随后的记录是在下颌骨切割之前、下颌骨劈开期间以及下颌骨刚性固定之后进行的。对基线数据的分析确定了刺激后 20 和 26 毫秒处的一系列峰值。 This biphasic response was consistent across subjects and was chosen for subsequent analysis.当神经向内侧回缩并进行内侧水平骨切割时，反应的幅度和潜伏期均受到显着影响（P 小于 0.05）。然而，所有患者的波形在 10 至 20 分钟内恢复到基线值。在手术过程中其他时间记录的诱发电位没有发现一致的变化。结果表明，手术牵拉可能会导致短暂的神经失用，但它们不能解释术后感觉丧失，这可能是由于其他因素（例如水肿和肿胀）造成的。
The inferior alveolar branch of the trigeminal nerve is at risk during sagittal split osteotomies, a common maxillofacial surgical procedure. The purpose of this study was to evaluate the use of somatosensory evoked potentials to assess the functional state of the nerve during surgery. Ten patients scheduled for bilateral sagittal split osteotomies were studied. Recording electrodes were placed on the scalp overlying vertex and inion, and subcutaneous stimulating electrodes were inserted 1 cm apart over the mental foramina. Recordings were made bilaterally from all patients. Baseline recordings were made after anesthetic induction, prior to the initial incision. Subsequent recordings were made just prior to the mandibular bone cuts, during splitting of the mandible, and after rigid fixation of the mandible. Analysis of the baseline data identified a series of peaks at 20 and 26 milliseconds following stimulation. This biphasic response was consistent across subjects and was chosen for subsequent analysis. Both the amplitude and latency of the response were significantly (P less than .05) affected when the nerve was retracted medially while the medial horizontal bone cuts were made. However, in all patients, the waveforms returned to baseline values within 10 to 20 minutes. No consistent changes were found in the evoked potentials recorded at other times during the surgical procedure. The results indicate that surgical retraction can cause a transient neurapraxia, but they do not account for postsurgical loss of sensation, which could be due to other factors, such as edema and swelling.