Intraoperative neurophysiological monitoring for benign peripheral nerve sheath tumor surgery
Intraoperative neurophysiological monitoring for benign peripheral nerve sheath tumor surgery is important in order to achieve maximal safe resection without compromising neurological function. 1) 2).
12% of a cohort had a permanent neurological complication, with new or worsened paresthesias most common, followed by pain and then weakness. Wilson et al. found that formal IONM was associated with a reduced likelihood of GTR and had no association with neurological complications. These data argue against IONM being considered the standard of care but do not believe that these data should be used to universally argue against IONM during resection of benign peripheral nerve sheath tumors 3).
1)
Jung IH, Yoon KW, Kim YJ, Lee SK. Analysis According to Characteristics of 18 Cases of Brachial Plexus Tumors : A Review of Surgical Treatment Experience. J Korean Neurosurg Soc. 2018 Sep;61(5):625-632. doi: 10.3340/jkns.2018.0045. Epub 2018 Aug 31. PMID: 30196660; PMCID: PMC6129745.
2)
Budohoski KP, Guilfoyle MR, Kenyon O, Barone DG, Santarius T, Trivedi RA. Microsurgical Resection of a Common Peroneal Nerve Schwannoma: A 3-Dimensional Operative Video. Oper Neurosurg (Hagerstown). 2018 Jan 1;14(1):83. doi: 10.1093/ons/opx066. PMID: 28521057.
3)
Wilson TJ, Hamrick F, Alzahrani S, Dibble CF, Koduri S, Pendleton C, Saleh S, Ali ZS, Mahan MA, Midha R, Ray WZ, Yang LJS, Zager EL, Spinner RJ. Analysis of the effect of intraoperative neuromonitoring during resection of benign nerve sheath tumors on gross-total resection and neurological complications. J Neurosurg. 2021 Feb 12:1-10. doi: 10.3171/2020.8.JNS202885. Epub ahead of print. PMID: 33578389.