Abstract
In the early days of intraoperative monitoring, either custom-made equipment or equipment taken from the clinical testing laboratory of the neurophysiological animal laboratories was used in the operating room. Now, there is specialized equipment commercially available for nearly all needs of intraoperative monitoring. This means that the persons who perform monitoring and intraoperative neurophysiology do not need to know as much about recording and stimulating equipment as they once did. However, knowledge about the basic function of the equipment that is used for intraoperative monitoring enables optimal use of the equipment and is important for troubleshooting. The equipment now commonly utilized for intraoperative neurophysiology is capable of appropriate signal processing, has several ways of filtering the recorded responses, and has many options for displaying the potentials recorded. The user must have sufficient knowledge, however, about the basis for filtering and signal averaging to use these methods in optimal ways.
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Notes
- 1.
The decibel scale is a logarithmic measure of ratios, such as the ratio between the amplitude of the output and that of the input; thus, it is a measure of attenuation or amplification. For voltage ratios, it is defined as 20 log10 E o/E i, where E i is the input voltage and E o is the output voltage, an attenuation of 3 dB means that the output is 0.707 times the input, a 6 dB attenuation means that the output voltage is half of the input, a 10 dB attenuation means that the output is 0.3 of the input, a 20 dB attenuation means that the output is 0.1 of the input, and so on.
References
Møller AR and PJ Jannetta (1984) Preservation of facial function during removal of acoustic neuromas: Use of monopolar constant voltage stimulation and EMG. J. Neurosurg. 61:757–60.
Yingling C (1994) Intraoperative monitoring in skull base surgery, in Neurotology, RK Jackler and DE Brackmann, Editors. Mosby: St. Louis. 967–1002.
Stecker MM (2004) Nerve stimulation with an electrode of finite size: Differences between constant current and constant voltage stimulation. Comput. Biol. Med. 34:51–94.
Yingling C and J Gardi (1992) Intraoperative monitoring of facial and cochlear nerves during acoustic neuroma surgery. Otolaryngol. Clin. North Am. 25:413–48.
Prass R and H Lueders (1985) Constant-current versus constant-voltage stimulation. J. Neurosurg. 62(4):622–3.
Kartush J and K Bouchard (1992) Intraoperative facial monitoring. Otology, neurotology, and skull base surgery, in Neuromonitoring in Otology and Head and Neck Surgery, J Kartush and K Bouchard, Editors. Raven Press: New York. 99–120.
Møller AR (2006) Hearing: Anatomy, Physiology, and Disorders of the Auditory System, 2nd Ed. Amsterdam: Academic Press.
Møller AR (1987) Electrophysiological monitoring of cranial nerves in operations in the skull base, in Tumors of the Cranial Base: Diagnosis and Treatment, LN Sekhar and VL Schramm Jr., Editors. Futura Publishing Co.: Mt. Kisco, New York. 123–32.
Pratt H, WH Martin, N Bleich et al (1994) A high-intensity, goggle-mounted flash stimulator for short-latency visual evoked potentials. Electroencephalogr. Clin. Neurophysiol. 92:469–72.
Prass RL, SE Kinney, RW Hardy et al (1987) Acoustic (loudspeaker) facial electromyographic monitoring: Part II. Use of evoked EMG activity during acoustic neuroma resection. Otolaryngol. Head Neck Surg. 97:541–51.
Prass RL and H Lueders (1986) Acoustic (loudspeaker) facial electromyographic monitoring. Part I. Neurosurgery 19(3):392–400.
Jako G (1965) Facial nerve monitor. Trans. Am. Acad. Ophthalmol. Otolaryngol. 69:340–2.
Sugita K and S Kobayashi (1982) Technical and instrumental improvements in the surgical treatment of acoustic neurinomas. J. Neurosurg. 57(6):747–52.
Lanser M, R Jackler and C Yingling (1992) Regional monitoring of the lower (ninth through twelfth) cranial nerves, in Intraoperative Monitoring in Otology and Head and Neck Surgery, J Kartush and K Bouchard, Editors. Raven Press: New York. 131–50.
MacDonald D (2001) Indiividually optimizing posterior tibial somatosensory evoked potential P37 scalp derivations for intraoperative monitoring. J. Clin. Neurophysiol. 18:364–71.
Hoke M, B Ross, R Wickesberg et al (1984) Weighted averaging: Theory and application to electrical response audiometry. Electroencephalogr. Clin. Neurophysiol. 57:484–9.
Sgro J, R Emerson and T Pedley (1989) Methods for steadily updating the averaged responses during neuromonitoring, in Neuromonitoring in Surgery, J Desmedt, Editor. Elsevier Science Publishers: Amsterdam. 49–60.
Elberling C (1984) Quality estimation of averaged auditory brainstem responses. Scand. Audiol. 13:187–97.
Muhler R and H von Specht (1999) Sorted averaging: Principle and application to auditory brainstem responses. Scand. Audiol. 28:145–9.
Schimmel H (1967) The (+/−) reference: Accuracy of estimated mean components in average response studies. Science 157:92–4.
Wong PKH and RG Bickford (1980) Brain stem auditory potentials: The use of noise estimate. Electroencephalogr. Clin. Neurophysiol. 50:25–34.
Doyle DJ and ML Hyde (1981) Analogue and digital filtering of auditory brainstem responses. Scand. Audiol. 10(2):81–9.
Boston JR and PJ Ainslie (1980) Effects of analog and digital filtering on brain stem auditory evoked potentials. Electroencephalogr. Clin. Neurophysiol. 48:361–4.
Janssen R, VA Benignus, LM Grimes et al (1986) Unrecognized errors due to analog filtering of brain-stem auditory evoked responses. Electroencephalogr. Clin. Neurophysiol. 65:203–11.
Doyle DJ and ML Hyde (1981) Bessel filtering of brain stem auditory evoked potentials. Electroencephalogr. Clin. Neurophysiol. 51:446–8.
Møller AR (1988) Use of zero-phase digital filters to enhance brainstem auditory evoked potentials (BAEPs). Electroencephalogr. Clin. Neurophysiol. 71:226–32.
Møller AR (1988) Evoked potentials in intraoperative monitoring. Baltimore: Williams and Wilkins.
Møller MB and AR Møller (1983) Brainstem auditory evoked potentials in patients with cerebellopontine angle tumors. Ann. Otol. Rhinol. Laryngol. 92:645–50.
Boston JR and AR Møller (1985) Brainstem auditory evoked potentials. Crit. Rev. Biomed. Eng. l3(2):97–123.
Walter DO (1969) A posterior “Wiener filtering” of average evoked responses. Electroencephalogr. Clin. Neurophysiol. 27:61–70.
Doyle DJ (1975) Some comments on the use of Wiener filtering for the estimation of evoked potentials. Electroencephalogr. Clin. Neurophysiol. 38:533–4.
Gonzalez RC (1977) Digital image processing. Boston MA: Addison-Wesley Publishing Co.
Lin BS, FC Chong and F Lai (2005) Adaptive filtering of evoked potentials using higher-order adaptive signal enhancer with genetic-type variable step-size prefilter. Med. Biol. Eng. Comput. 43:638–47.
Lam BS, Y Hu, WW Lu et al (2004) Validation of an adaptive signal enhancer in intraoperative somatosensory evoked potentials monitoring. J. Clin. Neurophysiol. 21:409–17.
Happel L and D Kline (2002) Intraoperative Neurophysiology of the Peripheral Nervous System, in Neurophysiology in Neurosurgery, V Deletis and JL Shils, Editors. Academic Press: Amsterdam. 169–95.
Happel L and D Kline (1991) Nerve lesions in continuity, in Operative nerve repair and reconstruction 1st ed vol 1, RH Gelberman, Editor. J.B. Lippincott: Philadelphia. 601–16.
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Møller, A.R. (2011). Equipment, Recording Techniques, and Data Analysis and Stimulation. In: Intraoperative Neurophysiological Monitoring. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-7436-5_18
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DOI: https://doi.org/10.1007/978-1-4419-7436-5_18
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