• Users Online: 454
  • Print this page
  • Email this page
 
ORIGINAL ARTICLE
Ahead of Print

Correlation between intraoperative mapping and monitoring and functional outcomes following supratentorial glioma surgery


1 Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan
2 Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan
3 Department of Neurosurgery, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan

Correspondence Address:
Tsui-Fen Yang,
Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, 201, Section 2, Shipai Road, Beitou District, Taipei
Taiwan
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tcmj.tcmj_270_20

Objective: Intraoperative neurophysiological monitoring (IONM) has long been regarded as the “gold standard” when resecting a supratentorial glioma, as it facilitates the goals of maximal tumor resection and preservation of sensorimotor function. The purpose of the present study was to evaluate the ability of motor evoked potentials (MEPs) monitoring or subcortical mapping (SCM), alone or in combination, to predict postoperative functional outcomes in glioma surgery. Materials and Methods: We retrospectively reviewed patients with supratentorial glioma that underwent craniotomy for tumor removal with IONM. Statistical analyses were used to evaluate whether the following criteria correlated with postoperative functional outcomes: Reduced amplitude (>50% reduction) or disappearance of MEPs (criterion 1), SCM with a stimulation intensity threshold less than 3 mA (criterion 2), the presence of both two phenomena (criterion 3), or either one of the two phenomena (criterion 4). Results: Ninety-two patients were included in this study, of whom 15 sustained new postoperative deficits, 4 experienced improved functional status, and 73 were unchanged. Postoperative functional status correlated significantly with all four criteria, and especially with criterion 3 (r = 0.647, P = 0.000). Sensitivity of IONM was better if using criteria 2 and 4, but specificity was better if using criteria 1 and 3. Criterion 3 had the most favorable overall results. Conclusion: Using statistical methodology, our study indicates that concomitant interpretation of MEPs and SCM is the most accurate predictor of functional outcomes following supratentorial glioma surgery. However, accurate interpretations of the monitoring results by experienced neurophysiologists are essential.


Print this article
Search
 Back
 
  Search Pubmed for
 
    -  Wu HL
    -  Hsu PC
    -  Hsu SP
    -  Lin CF
    -  Liao KK
    -  Yang KM
    -  Chou CL
    -  Yang TF
 Citation Manager
 Article Access Statistics
 Reader Comments
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed266    
    PDF Downloaded7    

Recommend this journal