gms | German Medical Science

59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

01. - 04.06.2008, Würzburg

Does electrode montage influence quality of intraoperative monitoring?

Beeinflusst die Elektrodenmontage die Qualität des intraoperativen Monitoring?

Meeting Abstract

  • corresponding author S. Rampp - Klinik und Poliklinik für Neurochirurgie, Martin-Luther-Universität Halle-Wittenberg
  • J. Prell - Klinik und Poliklinik für Neurochirurgie, Martin-Luther-Universität Halle-Wittenberg
  • J. Rachinger - Klinik und Poliklinik für Neurochirurgie, Martin-Luther-Universität Halle-Wittenberg
  • C. Scheller - Klinik und Poliklinik für Neurochirurgie, Martin-Luther-Universität Halle-Wittenberg
  • C. Strauss - Klinik und Poliklinik für Neurochirurgie, Martin-Luther-Universität Halle-Wittenberg

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocP 092

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2008/08dgnc360.shtml

Veröffentlicht: 30. Mai 2008

© 2008 Rampp et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective: Continuous recording of electromyographic signals (EMG) is an established method for intraoperative monitoring of facial nerve function in cerebello-pontine angle surgery. Since there is no standard electrode montage, we have compared two commonly used methods according to Møller and Kartush with respect to sensitivity to A-train activity, which is closely related to postoperative nerve function.

Methods: A group of 10 patients (8 female, 2 male) with A-train activity during vestibular schwannoma surgery were examined. Continuous EMG from facial muscles was recorded using needle electrodes in montages according to Kartush and Møller with narrow, respectively wide interelectrode distances. Quantity of pathological A-train activity and signal-to-noise ratios were compared between montages.

Results: A-train activity ranged from 0.44s to 421.32s, median 17.36s in the Kartush montage and from 0.98s to 6.16s, median 1.58s in the montage according to Møller. In 7 of 10 patients, Kartush showed an increased amount of traintime compared to Møller. On average, 96% of all A-train activity was seen in the Kartush montage, 37% was exclusively detectable, without detectable correlate in the Møller channel. The Møller setup showed an average of 63% of total A-train activity, only 4% were exclusive. The wide interelectrode distance Møller Montage was found to be significantly more susceptible to artefacts, especially to low frequency and power line noise. Artefacts were the main reason for the Møller setup to fail detecting A-train activity.

Conclusions: Both montages were able to detect A-train activity. The montage according to Møller is however very susceptible to artefacts. Additional artefact filtering is needed which bears the danger of distorting A-train waveforms. For continuous intraoperative monitoring of facial nerve function, narrow inter-electrode distance Kartush montage or adequate filtering should be used.