Feasibility of Intraoperative Somatosensory Evoked Potential Monitoring for Resection of Brachial Plexus Schwannomas
Journal
Annals of Plastic Surgery
Journal Volume
94
Journal Issue
3S
Start Page
S52
End Page
S57
ISSN
1536-3708
0148-7043
Date Issued
2025-03-01
Author(s)
Wen-Teng Yao
Hsiu-Han Hsu
Muh-Lii Liang
Hsuan-Yu Huang
Amy Hsuan-Chih Lao
Chia-Meng Yu
Kwang-Yi Tung
Shan-Chiao Yang
Chih-Peng Tu
Ming-Feng Tsai
Abstract
Objectives: The complex anatomical location of brachial plexus tumors is a formidable diagnostic and therapeutic challenge for surgeons. Intraoperative neurophysiologic monitoring enables the surgeon to proceed with more aggressive maneuvers for near total removal of the spinal cord tumor, such as somatosensory evoked potentials (SSEPs) monitoring. The present study aimed to describe the SSEP-assisted microsurgical excision technique and to evaluate the surgical outcomes of brachial plexus schwannomas. Methods: Thirteen patients who underwent SSEP-guided microsurgery for brachial plexus schwannomas between October 2011 and December 2020 were included in our study. Results: The mean age of the patients was 50 years (range, 29–64 years), with six tumors localized on the right, six on the left side and one on bilateral sides. Eight patients had preoperative motor/sensory dysfunction. Compared to preoperative Visual Analogue Scale (VAS) pain score, the postoperative VAS score significantly decreased in these patients (P = 0.005). No postoperative neurovascular injury was observed in the patients. Among patients who had a preoperative neurologic deficit, these preoperative neurologic deficits were relieved or improved after surgery. There was a low disability in the arm, shoulder, and hand after surgery. Conclusions: Brachial plexus schwannomas is able to completely excised by SSEP-assisted delicately surgical techniques, contributing to a surgical benefit for the excision of brachial plexus schwannomas, particularly in patients with lower trunk involvement.
Subjects
brachial plexus schwannomas
neurologic deficit
neurovascular injury
pain
somatosensory evoked potentials
SDGs
Publisher
Ovid Technologies (Wolters Kluwer Health)
Type
journal article