Intraoperative Monitoring of Evoked Potentials in Microvascular Decompression Operations: Influence on Surgical Strategy
Neurophysiologic monitoring of patients during microvascular decompression (MVD) operations to treat cranial nerve disorders in the cerebellopontine angle (CPA) has become essential not only to the decrease in morbidity of these operations that now makes them a desirable option for patients with disorders such as hemifacial spasm and trigeminal neuralgia, but in some cases to the efficient completion of the procedure itself.
Because the surgeon must devote primary attention to events in the operative field, monitoring of evoked potentials during operations in the CPA must be the primary responsibility of another professional on the surgical team. When the electrophysiologist and the surgeon establish a collaborative relationship so that they communicate well and coordinate their efforts, solutions can be found to the many problems that arise during the performance and monitoring of surgical maneuvers in the CPA.
Specific situations in which intraoperative monitoring facilitates the surgical goals of MVD, and ways in which the surgical strategy may be altered because of monitoring, are discussed.
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