Intraoperative Changes in BAEP and EMG During Microvascular Decompression
By Admin | August 17, 2023
Trigeminal neuralgia inflicts agonizing facial pain on patients. For many, the last vestiges of hope lie in a microvascular decompression procedure. This surgical solution relieves the pressure on the trigeminal nerve, alleviating that facial pain. Incorporating neuromonitoring in this procedure, provides transformative benefits that safeguard nerve integrity and enhance patient outcomes.
Meet our 67-year-old female patient, burdened by trigeminal neuralgia's relentless “electric shock-like” pain in her lower cheek and eye. Simple tasks like chewing and brushing her teeth were painful, leaving her desperate for relief.
With neuromonitoring at the forefront, the surgical team left no stone unturned to protect the patient's sensory and motor functions. Utilizing cutting-edge techniques like somatosensory evoked potentials (SSEPs), electroencephalography (EEG), brainstem auditory evoked potentials (BAEPs), and spontaneous electromyography (sEMG), safeguarding nerve integrity was the utmost priority.
During the procedure, the neuromonitoring team identified increased latency in the left BAEP waves, attributed to a surgical retractor's pressure. The surgical team expedited the procedure to promptly remove the retractor, preserving the auditory nerve's integrity and securing the patient's sense of hearing.
Neuromonitoring's watchful eye also caught train EMG activity in the left oris muscle, associated with the facial nerve. Armed with this information, the surgical team navigated with precision, ensuring the patient's facial nerve remained untouched, reducing any potential complications.
Postoperatively, the patient's progress was awe-inspiring. She effortlessly followed verbal commands, joyfully moved her facial muscles, and, most importantly, found freedom from the tormenting facial pain.
Neuromonitoring proved its pivotal role in preserving the auditory nerve's integrity and shielding the patient's hearing ability. “The swift action taken upon detecting the increased latency in the left BAEP averted potential hearing impairment, securing a life-changing benefit,” said Kathryn Overzet Jaquez, VP of Clinical Development at Axis Neuromonitoring in Richardson, TX.
The train activity observed in the left oris EMG empowered the surgical team to navigate around the facial nerve with absolute clarity. This careful maneuvering granted the patient a smooth and successful procedure, unlocking the full potential of microvascular decompression.
Microvascular decompression brings hope to trigeminal neuralgia sufferers, and neuromonitoring makes it possible to provide the best possible outcomes. Through SSEPs, EEG, BAEPs, and sEMG, neuromonitoring safeguards nerve functions, ensuring a transformative outcome for patients. At Axis Neuromonitoring, patient well-being remains at the heart of our commitment to high-quality intraoperative neurophysiological monitoring (IONM). For more information about the benefits of neuromonitoring and its profound impact on surgical outcomes, please contact us at 888-344-2947.
