Reliability of intraoperative visual evoked potentials (iVEPs) in monitoring visual function during endoscopic transsphenoidal surgery.
Endoscopic endonasal surgery
Neuromonitoring
Pituitary adenoma
Transsphenoidal
Visual evoked potentials
Journal
Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000
Informations de publication
Date de publication:
11 2023
11 2023
Historique:
received:
08
03
2023
accepted:
23
08
2023
medline:
6
11
2023
pubmed:
21
9
2023
entrez:
21
9
2023
Statut:
ppublish
Résumé
To refine a reliable and reproducible intraoperative visual evoked potentials (iVEPs) monitoring protocol during endoscopic transsphenoidal surgery. To assess the reliability of baseline iVEPs in predicting preoperative visual status and perioperative iVEP variation in predicting postoperative visual outcome. Sixty-four patients harboring tumors of the pituitary region were included. All patients underwent endoscopic endonasal approach (EEA) with iVEPs monitoring, using a totally intravenous anesthetic protocol. Ophthalmological evaluation included visual acuity and visual field studies. Preoperatively, visual acuity was reduced in 86% and visual field in 76.5% of cases. Baseline iVEPs amplitude was significantly correlated with preoperative visual acuity and visual field (p = 0.001 and p = 0.0004, respectively), confirming the reliability of the neurophysiological/anesthetic protocol implemented. Importantly, perioperatively the variation in iVEPs amplitude was significantly correlated with the changes in visual acuity (p < 0.0001) and visual field (p = 0.0013). ROC analysis confirmed that iVEPs are an accurate predictor of perioperiative visual acuity improvement, with a 100% positive predictive value in patients with preoperative vision loss. iVEPs during EEA is highly reliable in describing preoperative visual function and can accurately predict postoperative vision improvement. iVEPs represent a promising resource for carrying out a more effective and safe endoscopic transsphenoidal surgery.
Identifiants
pubmed: 37733080
doi: 10.1007/s00701-023-05778-1
pii: 10.1007/s00701-023-05778-1
pmc: PMC10624729
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
3421-3429Informations de copyright
© 2023. The Author(s).
Références
Neurol Med Chir (Tokyo). 2014;54(8):606-11
pubmed: 25070017
J Clin Monit Comput. 2014 Jun;28(3):275-85
pubmed: 24233355
Anesthesiology. 1998 May;88(5):1170-82
pubmed: 9605675
J Neurosurg. 2011 Feb;114(2):286-300
pubmed: 20815698
J Neurosurg Anesthesiol. 2003 Jan;15(1):19-24
pubmed: 12499978
Neurosurg Rev. 2020 Feb;43(1):177-183
pubmed: 30288662
Laryngoscope. 2006 Oct;116(10):1882-6
pubmed: 17003708
Clin Neurophysiol. 2017 Oct;128(10):2006-2013
pubmed: 28837906
Neurosurg Focus. 2005 Dec 15;19(6):E3
pubmed: 16398480
Ophthalmic Surg Lasers Imaging. 2007 May-Jun;38(3):250-3
pubmed: 17552396
J Neurosurg. 2016 Oct;125(4):888-897
pubmed: 26894463
J Neurosurg Sci. 2022 Oct;66(5):425-433
pubmed: 32043848
Dev Ophthalmol. 1984;9:108-14
pubmed: 6526096
Br J Neurosurg. 1996 Jun;10(3):275-8
pubmed: 8799538
Neurosurgery. 1987 Nov;21(5):709-15
pubmed: 3696406
Neurol India. 2018 Jul-Aug;66(4):1075-1080
pubmed: 30038097
World Neurosurg. 2019 Jun;126:e136-e143
pubmed: 30794978
Transl Vis Sci Technol. 2019 Nov 20;8(6):21
pubmed: 31788350
Surg Neurol. 1976 Jun;5(6):323-9
pubmed: 180620
J Neurosurg. 2010 Feb;112(2):273-84
pubmed: 19199497
Acta Neurochir (Wien). 2010 Apr;152(4):643-8
pubmed: 20127123
Doc Ophthalmol. 1988 Jul;69(3):271-81
pubmed: 3168727
PLoS One. 2015 Mar 24;10(3):e0120525
pubmed: 25803287
J Neurosurg. 2018 Mar 30;130(2):654-660
pubmed: 29600911
BMC Neurol. 2021 Jul 23;21(1):287
pubmed: 34301198
Doc Ophthalmol. 2016 Aug;133(1):1-9
pubmed: 27443562
J Anesth. 2020 Apr;34(2):298-302
pubmed: 31950267
Acta Neurochir (Wien). 2017 Jun;159(6):1043-1048
pubmed: 28190146
Neurosurgery. 1979 Nov;5(5):553-8
pubmed: 534063
J Neurosurg. 1976 Jan;44(1):29-31
pubmed: 1244432
Acta Neurochir (Wien). 2012 Aug;154(8):1505-10
pubmed: 22739773