Impact of intraoperative recurrent laryngeal nerve monitoring on minimally invasive esophagectomy outcomes for esophageal cancer: a meta-analysis of case-control studies.

Esophagectomy and lymphadenectomy for esophageal cancer carry an inherent risk of recurrent laryngeal nerve (RLN) injury. Intraoperative nerve monitoring (IONM) may help prevent RLN damage, though evidence on its effectiveness is still limited. This systematic review and meta-analysis (SRMA) evaluate the feasibility and efficacy of IONM during minimally invasive esophagectomy (MIE) for esophageal cancer.

Application of continuous intraoperative neuromonitoring in the study of spinal nerve root thermal injury in a porcine model.

Background: A warning system to avoid potential nerve root thermal injury caused by automatic spine robot is essential. However, there is a lack of basic research to support the development of such warning system. The aims of this study are to confirm the feasibility of continuous intraoperative neuromonitoring (CIONM) in spinal nerve root monitoring and study the exposure time of spinal nerve root thermal injury at different temperature in a porcine model.

Role of the Laryngeal Adductor Reflex in the Prevention of Thermal Injury to the Recurrent Laryngeal Nerve in Thyroid Surgery: A Case Report.

Background: Intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) aims to detect and prevent iatrogenic damage during thyroid surgery. Mechanisms of injury include traction, heat damage, and nerve transection. Continuous IONM (C-IONM) techniques detect impending damage due to traction and heat related when they are still reversible.

Olfactory Evoked Potential Monitoring: Technical Note and Challenges Faced.

Background And Aim: Despite the sustained progress in the realm of intraoperative neurophysiologic monitoring of the nervous system, little progress has been achieved in monitoring the olfactory pathway. Loss of olfactory function due to retraction-induced physical damage during operations has ill-appreciated negative consequences for the patients and is often underreported. Improvements in this area of neuromonitoring require a revisit of the technical challenges.

The Value of Intraoperative Neurophysiological Monitoring During Patient Positioning in Spine Surgery: A Preventive Strategy.

Cervical spine surgery in patients with myelopathy poses a substantial anesthetic challenge, primarily due to the risk of secondary spinal cord injury (SCI). Traditionally, concerns have centered around cervical movements during intubation. However, limited evidence supports a direct link between intubation and SCI, so anesthesiologists must consider other factors, including patient positioning, spinal perfusion pressure, and direct surgical complications.

Intraoperative Electrical Stapedius Reflex Testing to Monitor Cochlear Nerve Integrity during Simultaneous Vestibular Schwannoma Resection and Cochlear Implantation.

Objective: To compare the utility of intraoperative electrically evoked auditory brainstem response (eABR) and electrically evoked stapedial reflex testing (eSRT) for cochlear nerve integrity monitoring during simultaneous translabyrinthine resection of vestibular schwannoma (VS) and cochlear implantation.

Study Design: Historical cohort study.

Setting: Tertiary academic referral center.

Diagnostic accuracy of intraoperative pelvic autonomic nerve monitoring during rectal surgery: a systematic review.

Purpose: Anorectal and urogenital dysfunctions are common after rectal surgery and have a significant impact on quality of life. Intraoperative pelvic autonomic nerve monitoring (pIONM) has been proposed as a tool to identify patients at risk of these functional sequelae. This systematic review aims to evaluate the diagnostic accuracy of pIONM in detecting anorectal and urogenital dysfunction following rectal surgery.

Neurophysiological identification and differentiation between the motor and sensory roots in pediatric spinal cord lipoma surgery.

Background: Radical resection of spinal cord lipomas reduces the rate of re-tethering. Current conventional neurophysiological mapping techniques are not able to differentiate between crucial motor nerve roots and sensory roots. Enhanced differentiation could contribute to complete resection.

Response to ASNM intraoperative SSEP position statement.

This correspondence is in response to Dr. David Allison's comments to the Editor, regarding the American Society of Neurophysiological Monitoring's (ASNM) updated intraoperative somatosensory evoked potential (SEP) monitoring position statement.

Impact of low-dose sevoflurane with propofol-based anesthesia on motor-evoked potentials in infants: a single-arm crossover pilot study.

Purpose: The influence of anesthetic interactions on motor-evoked potentials in infants has rarely been reported. In infants, adding a small dose of sevoflurane to propofol-based total intravenous anesthesia is reasonable for reducing propofol administration. We collected preliminary data regarding the effect of low-dose sevoflurane in propofol-based total intravenous anesthesia on motor-evoked potentials in infants.

Intraoperative neuromonitoring and mapping during spinal cord untethering surgery; a single-centre paediatric neurosurgery unit experience.

Purpose: A review of intraoperative neuromonitoring (IONM) and mapping (IONMa) utility during paediatric tethered cord surgery with particular attention to feasibility, measures to prevent injury, and postoperative outcome.

Methods: A retrospective analysis of spinal cord untethering surgery between 2015 and 2022 was carried out. Cohort demographics, IONM and IONMa data, and procedural details were summarised and associations between variables explored.

Vagus Nerve Preservation for Early Distal Gastric Cancer With Monitoring and Indocyanine Green Labeling: A Randomized Clinical Trial.

Importance: Radical gastric cancer surgery can cause functional and physiological disorders due to the resection of perigastric vagus nerves. Few studies have used intraoperative neurophysiological monitoring and indocyanine green (ICG) labeling to preserve the perigastric vagus nerve and to evaluate the corresponding effects.

Objective: To assess the feasibility and effects of vagus nerve preservation using neurophysiologic monitoring and ICG labeling during laparoscopic distal gastrectomy in patients with early distal gastric cancer.

The influence of depth of sedation on motor evoked potentials monitoring in youth from 4 to 23 years old: preliminary data from a prospective observational study.

Introduction: The influence of various levels of sedation depth on motor evoked potentials (MEP) reproducibility in youth is still unclear because of a lack of data. We tested the hypothesis that a deeper level of total intravenous anesthesia (TIVA) [bispectral index (BIS) 40 ± 5 compared to 60 ± 5] can affect surgeon-directed MEP and their interpretation in youths.

Methods: All patients received TIVA combined with propofol and remifentanil.

Co-administration of dexmedetomidine with total intravenous anaesthesia in carotid endarterectomy reduces requirements for propofol and improves haemodynamic stability: A single-centre, prospective, randomised controlled trial.

Background: Total intravenous anaesthesia guided by electroencephalography and neurophysiological monitoring may be used for carotid endarterectomy. Reduction of brain metabolic demand during cross-clamping of the internal carotid artery with propofol titrated to burst suppression requires effect-site concentrations that may delay emergence and interfere with intraoperative neurophysiological monitoring.

Objective: To test the hypothesis that dexmedetomidine decreases the effect-site concentration of propofol required for burst-suppression in patients undergoing carotid endarterectomy.

Effect of ultrasound-guided internal branch of superior laryngeal nerve block on postoperative sore throat induced by a NIM-EMG-ETT: study protocol for a double-blinded randomized controlled trial.

Background: Postoperative sore throat (POST) is a common complaint after general anaesthesia. The prevalence of POST caused by a neural integrity monitor electromyography endotracheal tube (NIM-EMG-ETT) is high. This study aimed to determine whether ultrasound-guided internal branch of superior laryngeal nerve block (iSLNB) could alleviate POST associated with a NIM-EMG-ETT.

Transcranial MEPs predict clinical outcome during minimally invasive dorsal decompression for cervical spondylotic myelopathy.

Objectives: Motor evoked potential (MEP) monitoring is a reliable method for real-time assessment of corticospinal tract integrity. However, the potential benefits of MEP monitoring during degenerative spine surgery remain controversial. This study aims to determine the role of MEP monitoring during surgery for cervical spondylotic myelopathy (CSM) in prediction of prognosis.

Envisioning the Future of the Neurosurgical Operating Room with the Concept of the Medical Metaverse.

The medical metaverse can be defined as a virtual spatiotemporal framework wherein higher-dimensional medical information is generated, exchanged, and utilized through communication among medical personnel or patients. This occurs through the integration of cutting-edge technologies such as augmented reality (AR), virtual reality (VR), artificial intelligence (AI), big data, cloud computing, and others. We can envision a future neurosurgical operating room that utilizes such medical metaverse concept such as shared extended reality (AR/VR) of surgical field, AI-powered intraoperative neurophysiological monitoring, and real-time intraoperative tissue diagnosis.

Overcoming age: Slow anesthesia induction may prevent geriatric patients from developing burst suppression and help developing intraoperative EEG signatures of a younger brain.

Elderly patients are prone to develop postoperative neurocognitive deficits potentially precipitated by inadequate anesthetic management. To investigate the potential of EEG-guided individualized anesthetic titration we evaluated the effect of the patient's age on the spectral composition of the EEG during slow propofol induction. Twenty-six young (<65 years) and 25 old (≥65 years) patients received propofol until loss of responsiveness (LOR).