Correlation between intraoperative mapping and monitoring and functional outcomes following supratentorial glioma surgery
Objectives: Intraoperative neurophysiological monitoring (IONM) has long been regarded as the “gold standard” when resecting a supratentorial glioma, as it facilitates the goals of maximal tumor resection and preservation of sensorimotor function. The purpose of the present study was to evaluate the...
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| Format: | Article |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Tzu Chi Medical Journal |
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| Online Access: | http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2021;volume=33;issue=4;spage=395;epage=398;aulast=Wu |
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| author | Han-Lin Wu Po-Cheng Hsu Sanford P C Hsu Chun-Fu Lin Kwong-Kum Liao Kai-Ming Yang Chen-Liang Chou Tsui-Fen Yang |
| author_facet | Han-Lin Wu Po-Cheng Hsu Sanford P C Hsu Chun-Fu Lin Kwong-Kum Liao Kai-Ming Yang Chen-Liang Chou Tsui-Fen Yang |
| author_sort | Han-Lin Wu |
| collection | DOAJ |
| description | Objectives: Intraoperative neurophysiological monitoring (IONM) has long been regarded as the “gold standard” when resecting a supratentorial glioma, as it facilitates the goals of maximal tumor resection and preservation of sensorimotor function. The purpose of the present study was to evaluate the ability of motor evoked potentials (MEPs) monitoring or subcortical mapping (SCM), alone or in combination, to predict postoperative functional outcomes in glioma surgery. Materials and Methods: We retrospectively reviewed patients with supratentorial glioma that underwent craniotomy for tumor removal with IONM. Statistical analyses were used to evaluate whether the following criteria correlated with postoperative functional outcomes: Reduced amplitude (>50% reduction) or disappearance of MEPs (criterion 1), SCM with a stimulation intensity threshold less than 3 mA (criterion 2), the presence of both two phenomena (criterion 3), or either one of the two phenomena (criterion 4). Results: Ninety-two patients were included in this study, of whom 15 sustained new postoperative deficits, 4 experienced improved functional status, and 73 were unchanged. Postoperative functional status correlated significantly with all four criteria, and especially with criterion 3 (r = 0.647, P = 0.000). Sensitivity of IONM was better if using criteria 2 and 4, but specificity was better if using criteria 1 and 3. Criterion 3 had the most favorable overall results. Conclusion: Using statistical methodology, our study indicates that concomitant interpretation of MEPs and SCM is the most accurate predictor of functional outcomes following supratentorial glioma surgery. However, accurate interpretations of the monitoring results by experienced neurophysiologists are essential. |
| format | Article |
| id | doaj-art-d89ae692a4ac40a38b3eaac323ddb62f |
| institution | OA Journals |
| issn | 1016-3190 2223-8956 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Tzu Chi Medical Journal |
| spelling | doaj-art-d89ae692a4ac40a38b3eaac323ddb62f2025-08-20T02:28:10ZengWolters Kluwer Medknow PublicationsTzu Chi Medical Journal1016-31902223-89562021-01-0133439539810.4103/tcmj.tcmj_270_20Correlation between intraoperative mapping and monitoring and functional outcomes following supratentorial glioma surgeryHan-Lin WuPo-Cheng HsuSanford P C HsuChun-Fu LinKwong-Kum LiaoKai-Ming YangChen-Liang ChouTsui-Fen YangObjectives: Intraoperative neurophysiological monitoring (IONM) has long been regarded as the “gold standard” when resecting a supratentorial glioma, as it facilitates the goals of maximal tumor resection and preservation of sensorimotor function. The purpose of the present study was to evaluate the ability of motor evoked potentials (MEPs) monitoring or subcortical mapping (SCM), alone or in combination, to predict postoperative functional outcomes in glioma surgery. Materials and Methods: We retrospectively reviewed patients with supratentorial glioma that underwent craniotomy for tumor removal with IONM. Statistical analyses were used to evaluate whether the following criteria correlated with postoperative functional outcomes: Reduced amplitude (>50% reduction) or disappearance of MEPs (criterion 1), SCM with a stimulation intensity threshold less than 3 mA (criterion 2), the presence of both two phenomena (criterion 3), or either one of the two phenomena (criterion 4). Results: Ninety-two patients were included in this study, of whom 15 sustained new postoperative deficits, 4 experienced improved functional status, and 73 were unchanged. Postoperative functional status correlated significantly with all four criteria, and especially with criterion 3 (r = 0.647, P = 0.000). Sensitivity of IONM was better if using criteria 2 and 4, but specificity was better if using criteria 1 and 3. Criterion 3 had the most favorable overall results. Conclusion: Using statistical methodology, our study indicates that concomitant interpretation of MEPs and SCM is the most accurate predictor of functional outcomes following supratentorial glioma surgery. However, accurate interpretations of the monitoring results by experienced neurophysiologists are essential.http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2021;volume=33;issue=4;spage=395;epage=398;aulast=Wufunctional outcomeintraoperative neurophysiological monitoringmotor evoked potentialssubcortical mapping |
| spellingShingle | Han-Lin Wu Po-Cheng Hsu Sanford P C Hsu Chun-Fu Lin Kwong-Kum Liao Kai-Ming Yang Chen-Liang Chou Tsui-Fen Yang Correlation between intraoperative mapping and monitoring and functional outcomes following supratentorial glioma surgery Tzu Chi Medical Journal functional outcome intraoperative neurophysiological monitoring motor evoked potentials subcortical mapping |
| title | Correlation between intraoperative mapping and monitoring and functional outcomes following supratentorial glioma surgery |
| title_full | Correlation between intraoperative mapping and monitoring and functional outcomes following supratentorial glioma surgery |
| title_fullStr | Correlation between intraoperative mapping and monitoring and functional outcomes following supratentorial glioma surgery |
| title_full_unstemmed | Correlation between intraoperative mapping and monitoring and functional outcomes following supratentorial glioma surgery |
| title_short | Correlation between intraoperative mapping and monitoring and functional outcomes following supratentorial glioma surgery |
| title_sort | correlation between intraoperative mapping and monitoring and functional outcomes following supratentorial glioma surgery |
| topic | functional outcome intraoperative neurophysiological monitoring motor evoked potentials subcortical mapping |
| url | http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2021;volume=33;issue=4;spage=395;epage=398;aulast=Wu |
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