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O Suess

Publications and source records attributed to O Suess.

21 records · Page 2Linked to original sources

Can continuous intraoperative facial electromyography predict facial nerve function following cerebellopontine angle surgery?

Intraoperative cranial nerve monitoring has significantly improved the preservation of facial nerve function following surgery in the cerebellopontine angle (CPA). Facial electromyography (EMG) was performed in 60 patients during CPA surgery. Pairs of needle electrodes were placed subdermally in the orbicularis oris and orbicularis oculi muscles. The duration of facial EMG activity was noted. Facial EMG potentials occurring in response to mechanical or metabolic irritation of the corresponding nerve were made audible by a loudspeaker. Immediate (4-7 days after tumor excision) and late (6 months after surgery) facial nerve function was assessed on a modified House-Brackmann scale. Late facial nerve function was good (House-Brackmann 1-2) in 29 of 60 patients, fair (House-Brackmann 3-4) in 14, and poor (House-Brackmann 5-6) in 17. Postmanipulation facial EMG activity exceeding 5 minutes in 15 patients was associated with poor late function in five, fair function in six, and good function in four cases. Postmanipulation facial EMG activity of 2-5 minutes in 30 patients was associated with good late facial nerve function in 20, fair in eight, and poor in two. The loss of facial EMG activity observed in 10 patients was always followed by poor function. Facial nerve function was preserved postoperatively in all five patients in whom facial EMG activity lasted less than 2 minutes. Facial EMG is a sensitive method for identifying the facial nerve during surgery in the CPA. EMG bursts are a very reliable indicator of intraoperative facial nerve manipulation, but the duration of these bursts do not necessarily correlate with short- or long-term facial nerve function despite the fact that burst duration reflects the severity of mechanical aggression to the facial nerve.

Cranial Fossa, Posterior↗

Comparison between monopolar and bipolar electrical stimulation of the motor cortex.

Intra-operative neurophysiological techniques allow reliable identification of the sensorimotor region and make their anatomical and functional preservation feasible. Monopolar cortical stimulation has recently been described as a new mapping technique. In the present study this method was compared to the "traditional" technique of bipolar stimulation. Functional mapping of the motor cortex was performed in 35 patients during surgery in the central region. The central sulcus (CS) was identified by somatosensory evoked potential (SEP) phase reversal. Cortical motor mapping was first performed by monopolar anodal stimulation with a train of 500 Hz (7-10 pulses) followed by bipolar stimulation (pulses at 60 Hz with max. 4 sec train duration). Surgery was performed under general anaesthesia without muscle relaxants. Of 280 motor responses elicited by bipolar cortical stimulation, 54.23% [152] were located in the primary motor cortex (PMC), 37.85% 106[ outside the motor strip in the secondary motor cortex (SMC), and 8% 22[ posterior to the CS. Of 175 motor responses elicited by monopolar cortical stimulation. 68.57% 120[ were located in the SMC, 23.42% 41[ in the SMC and 8% 14[ posterior to the CS. Contrary to the general clinical view, there is considerable overlapping of primary motor units over a cortical area much broader than the "classical" narrow motor strip along the CS. Bipolar cortical stimulation is more sensitive than monopolar for mapping motor function in the premotor frontal cortex. Both methods are equally sensitive for mapping the primary motor cortex.

Adolescent↗

Neoplasm of endolymphatic sac origin: clinical, radiological and pathological features.

This paper reports on a 55-year-old female who had undergone middle ear surgery 12 years previously and was admitted with a 6-months history of unilateral hearing loss and facial weakness. MRI and CT demonstrated a space-occupying lesion arising from the temporal bone and extending into the posterior fossa. Treatment consisted in complete tumour removal. Temporal and mastoid bone destruction associated with typical histological features led to the diagnosis of neoplasm of endolymphatic sac origin. Clinical, histological, radiological and intra-operative features of these rare tumours are described and discussed. The pertinent literature is reviewed.

Cholesteatoma, Middle Ear↗