Application Of Neuroelectrophysiological Monitoring In Functional Glioma

Objective:To analyze the application of intraoperative neurophysiological monitoring(IONM)technique in the excision of functional glioma,and to explore the value of neurophysiological monitoring technique in the extensive resection of glioma in functional area.Discuss the effects of various neurophysiological monitoring techniques in operative glioma surgery,such as tumor resection rate,patient survival rate and patient function protection,and improvement of overall quality of life after surgery.Methods:10 patients with functional pathological changes of glioma in Sanbo Brain Hospital from January 20 to January 2019 were collected.All the techniques were monitored by neurophysiological monitoring.The preoperative preoperative imaging data of these patients were used for preliminary anatomical positioning.In the operation,neurophysiological monitoring techniques were combined according to the specific part of the tumor,including:Somatosensory Evoked Potential(SEP),Motor Evoked Potential,MEP),cortical electrical stimulation(ECS),electromyography(EMMG),localization of central sulcus and functional cortical areas and completion of intraoperative monitoring,assisted surgeons to complete the resection of the lesion under the microscope.Sequential experiments were used to collect patient medical records that met the inclusion criteria and exclusion criteria.The relevant evaluation records before and after surgery were analyzed and compared.The t-test was used to restore the neurological function and Karen scores of patients before and after surgery(Karnofsky,KPS).The value is measured.Results:According to the collected medical records,1 case of diffuse astrocytoma,1 case of dysplastic oligodendroglioma,1 case of oligodendroglioma,2 cases of mixed neuronal glioma,2 cases of colloidal mother There were 5 cases of cell tumor,5 cases of somatosensory evoked potential monitoring,3 cases of motor evoked potential monitoring,and 2 cases of cortical electrical stimulation.CT scan of the brain within 24 hours after surgery,according to the judgment of the surgeon under the microscope and postoperative imaging data:5 cases of total resection,5 cases of subtotal resection,all patients after the recovery of muscle strength after surgery are not lower than before surgery,according to There was no statistically significant difference in age and gender.Only one patient had no improvement in postoperative symptoms.The other 9 patients had reduced or disappeared symptoms.All patients did not present new functional impairment,and the quality of life of patients.Significantly improved than before surgery.Conclusion:The use of neuronavigation can help reduce the scope ofneurophysiological exploration,reduce cerebral cortex exposure,and combine functional nerve navigation to complete functional zone localization,thereby shortening the operation time.Continuous somatosensory evoked potentials and motor evoked potentials monitor the integrity of sensory and motor pathways during surgery.Through the cortical somatosensory evoked potentials,the central sulcus and the anterior and posterior gyrus were directly located.The direct cortical electrical stimulation monitored the integrity of the motor conduction pathway in real time during the resection of the lesion.In functional glioma surgery,neurophysiological monitoring techniques are compared with other techniques such as Image Guided Neurosurgery Sustem(IGNS)and Diffusion Tensor Imaging(DTI).Glioma surgery has its own unique advantages.Using neuronavigation and intraoperative neurophysiological monitoring,the central sulcus is localized by cortical electrical stimulation and somatosensory evoked potentials,and the sensation and motor function area are located by motor evoked potentials.At the same time as the nerve function is guaranteed,the tumor is removed and the tumor is degenerated.The cells ensure the safety of surgery and reduce the loss of postoperative neurological function.Under the close cooperation of technology advancement and accumulated experience,combined with navigation guidance,electrophysiological monitoring,and surgeons,the surgical function of cerebral gliomas will be better and safer,allowing patients to obtain more psychological comfort.