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Triggered Electrooculography for Identification of Oculomotor and Abducens Nerves during Skull Base Surgery

Authors
 Ha-Neul Jeong  ;  Sang-Il Ahn  ;  Minkyun Na  ;  Jihwan Yoo  ;  Woohyun Kim  ;  In-Ho Jung  ;  Soobin Kang  ;  Seung Min Kim  ;  Ha Young Shin  ;  Jong Hee Chang  ;  Eui Hyun Kim 
Citation
 JOURNAL OF KOREAN NEUROSURGICAL SOCIETY, Vol.64(2) : 282-288, 2021-03 
Journal Title
JOURNAL OF KOREAN NEUROSURGICAL SOCIETY
ISSN
 2005-3711 
Issue Date
2021-03
Keywords
Abducens nerve ; Electrooculography ; Monitoring , Intraoperative ; Oculomotor nerve
Abstract
Objective: Electrooculography (EOG) records eyeball movements as changes in the potential difference between the negatively charged retina and the positively charged cornea. We aimed to investigate whether reliable EOG waveforms can be evoked by electrical stimulation of the oculomotor and abducens nerves during skull base surgery.

Methods: We retrospectively reviewed the records of 18 patients who had undergone a skull base tumor surgery using EOG (11 craniotomies and seven endonasal endoscopic surgeries). Stimulation was performed at 5 Hz with a stimulus duration of 200 μs and an intensity of 0.1-5 mA using a concentric bipolar probe. Recording electrodes were placed on the upper (active) and lower (reference) eyelids, and on the outer corners of both eyes; the active electrode was placed on the contralateral side.

Results: Reproducibly triggered EOG waveforms were observed in all cases. Electrical stimulation of cranial nerves (CNs) III and VI elicited positive waveforms and negative waveforms, respectively, in the horizontal recording. The median latencies were 3.1 and 0.5 ms for craniotomies and endonasal endoscopic surgeries, respectively (p=0.007). Additionally, the median amplitudes were 33.7 and 46.4 μV for craniotomies and endonasal endoscopic surgeries, respectively (p=0.40).

Conclusion: This study showed reliably triggered EOG waveforms with stimulation of CNs III and VI during skull base surgery. The latency was different according to the point of stimulation and thus predictable. As EOG is noninvasive and relatively easy to perform, it can be used to identify the ocular motor nerves during surgeries as an alternative of electromyography.
Files in This Item:
T202102293.pdf Download
DOI
10.3340/jkns.2020.0179
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seung Min(김승민) ORCID logo https://orcid.org/0000-0002-4384-9640
Kim, Eui Hyun(김의현) ORCID logo https://orcid.org/0000-0002-2523-7122
Shin, Ha Young(신하영) ORCID logo https://orcid.org/0000-0002-4408-8265
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/184144
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