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TcMEP threshold change is superior to A-train detection when predicting facial nerve outcome in CPA tumour surgery by Tom Hendriks; Henricus P. M. Kunst; Maarten Huppelschoten; Jonne Doorduin; Mark Ter Laan is a Medicine article available to read on EtoBox.

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## Object Surgery of tumours in the cerebellopontine angle (CPA) can lead to loss of facial nerve function. Different methods of intra-operative nerve monitoring (IOM) (including free-running EMG, direct nerve stimulation and transcranial motor evoked potentials (TcMEP)) have been used to predict facial nerve outcome during surgery. Recent research has shown TcMEP threshold increase and the occurrence of A-trains on the EMG to have great potential in doing so. This study compares these two methods and correlates them to House-Brackmann (HB) scores post-op in patients with tumours in the cerebellopontine angle. ## Method Forty-three patients (one was operated twice) with large CPA tumours treated surgically in the Radboud University Medical Center between 2015 and 2019 were included in this study. During surgery, TcMEP threshold increases and A-train activity were measured. Because our treatment paradigm aims at facial nerve preservation (accepting residual tumour), TcMEP threshold increase of over 20 mA or occurrence of A-trains were considered as warning signs and used as a guide for terminating surgery. HB scores were measured post-op, at 6 weeks, 6 months and 1 year after surger

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Author

Tom Hendriks; Henricus P. M. Kunst; Maarten Huppelschoten; Jonne Doorduin; Mark Ter Laan

Publisher

Springer Vienna; Springer-Verlag; Springer Verlag; Springer Science and Business Media LLC; Society for Mining, Metallurgy and Exploration Inc. (ISSN 0001-6268)

Published

2020

Language

EN

Field

Medicine (Health Sciences)