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69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

03.06. - 06.06.2018, Münster

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Continuous subcortical monitoring improves surgical and functional outcome during resection of motor eloquent brain tumors

Meeting Abstract

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  • Sebastian Ille - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
  • Sandro Krieg - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
  • Florian Ringel - Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland
  • Bernhard Meyer - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
  • Ehab Shiban - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie. Münster, 03.-06.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocP184

doi: 10.3205/18dgnc525, urn:nbn:de:0183-18dgnc5251

Veröffentlicht: 18. Juni 2018

© 2018 Ille et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: Intraoperative motor evoked potentials (MEP) have increased patient's safety and extent of resection in patients with motor eloquent brain tumors. Subcortical stimulation has emerged as an additional tool that may improve functional and oncological outcome even more. However, it is mainly used as a mapping tool and reports of subcortical continuous monitoring are rare. The present study aims to evaluate the benefit of continuous subcortical mapping compared to standard subcortical mapping.

Methods: A retrospective analysis of 42 patients with motor eloquent brain tumors who were consecutively operated between January 2013 and August 2014 was performed. In the control group 21 patients were operated only with the use of transcranial or direct cortical MEP monitoring with intermittent subcortical mapping. In the study group 21 patients were operated with transcranial or direct cortical MEPs with the additional use of continuous subcortical monitoring by using the tip of the ultrasonic aspirator as a stimulation probe. The patient's motor status was evaluated preoperatively, 5 days and 3 months after surgery.

Results: 4 and 1 patients had a transient motor deficit in the control and study group, respectively. 4 and 2 patients had a permanent motor deficit in the control and study group, respectively. Gross total resection was achieved in 14 and 18 cases in the control and study group, respectively. Subtotal resections were achieved in 8 and 3 cases in the control and study group, respectively.

Conclusion: Continuous subcortical monitoring using the ultrasonic aspirator as a stimulation probe for the resection of motor eloquent brain lesions seems to improve functional and surgical outcome.