[Intraoperative identification of oculomotor, trochlear and abducent nerves in surgery of invasive cranioorbital tumors (new technique)].
BACKGROUND
Aim of the study was to evaluate effectiveness of intraoperative identification of oculomotor nerves (OMN) in resection of skull base tumors invading superior orbital fissure and cavernous sinus.


METHODS
69 patients with cranioorbital tumors operated in Burdenko Neurosurgical Institute (Moscow, Russia) since 2000 until 2005 were included in the study. They were divided into 2 groups: 19 patients treated with intraoperative identification of OMN and 50 patients in the control group. Craniorbital meningiomas were in the majority among all cases. Intraoperative identification of OMN was performed using coaxial electrode while muscular response was registered through electrodes inserted in m. levator palpebrae superioris, m. obliquus superior and m. rectus lateralis (for III, IV and VI cranial nerves, respectively). Identification of IMN trunci was repeated throughout the whole stage of tumor resection for their preservation.


RESULTS
comparison of dynamics of oculomotor dysfunction in early postoperative period in patients of both groups demonstrated that intraoperative identification of OMN allowed to decrease the frequency of oculomotor deficit. The rates in main and control groups were: for III and IV nerves--37% and 68% (p < 0.05), for VI nerve--47% and 54% (p > 0.05), respectively.


CONCLUSIONS
application of intraoperative identification of OMN allows to decrease the risk of oculomotor deterioration due to III and IV nerve dysfunction by 1.8 times. Technically the method is quite simple and not time-consuming procedure.
V A
VA
Cherekaev
G A
GA
Shchekut'ev
A A
AA
Ogurtsova
D A
DA
Gol'binh
R A
RA
Smirnov
D000010:Abducens Nerve / Q000473:pathology / Q000503:physiopathology; D000328:Adult; D000368:Aged; D004566:Electrodes; D053483:Eye Movement Measurements / Q000295:instrumentation*; D005133:Eye Movements; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000295:instrumentation / Q000379:methods; D008297:Male; D008579:Meningioma / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D015835:Ocular Motility Disorders / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D009918:Orbital Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D014321:Trochlear Nerve / Q000473:pathology / Q000503:physiopathology