Top

Published in:

01-06-2021 | Meningioma | Original Article

Electrophysiological predictors of hearing deterioration based on AEP monitoring during petroclival meningioma resection

Authors: Guilherme Lepski, Analía Arévalo, Florian Roser, M. Liebsch, Marcos Tatagiba

Published in: Neurosurgical Review | Issue 3/2021

Abstract

The objective of this study was to calculate the risk of postsurgical hearing deterioration as a function of changes in the amplitude and latency of the most stable components (waves III and V) of the auditory evoked potential (AEP) during petroclival meningioma resection surgery. We retrospectively analyzed intraoperative AEP monitoring results and pre- and postsurgical hearing status in 40 consecutive patients who were surgically treated for petroclival meningiomas. Statistical analyses were conducted to identify the most sensitive and specific way to predict hearing dysfunction after surgery. Patients’ mean age was 59 ± 10 years, and 31 (77.5%) were women. Twelve (30%) patients presented with clinically detectable hearing impairment preoperatively. At the first postoperative assessment, four of those 12 patients reported subjective improvement, and eight reported hearing deterioration. Of those eight, four remained stable and four recovered hearing by the last assessment. Wave III latency reached its highest specificity (100%) and sensitivity (71.43%) at x = 143%. Wave V latency, on the other hand, reached its highest sensitivity (71%) and specificity (93%) at x = 124%. Finally, wave V amplitude reached its highest sensitivity (100%) and specificity (79%) at x = 74%. Intraoperative alterations of wave III latency and wave V amplitude seem to be highly sensitive and specific at predicting the risk of auditory dysfunction in patients undergoing petroclival meningioma resection and should be used to determine maximum resection with preservation of function.

Available only for authorised users

Alexiou GA, Gogou P, Markoula S, Kyritsis AP (2010) Management of meningiomas. Clin Neurol Neurosurg 112(3):177–182PubMed

Almefty R, Dunn IF, Pravdenkova S, Abolfotoh M, Al-Mefty O (2014) True petroclival meningiomas: results of surgical management. J Neurosurg 120(1):40–51PubMed

Al-Mefty O, Ayoubi S, Gaber E (2002) Trigeminal schwannomas: removal of dumbbell-shaped tumors through the expanded Meckel cave and outcomes of cranial nerve function. J Neurosurg 96(3):453–463PubMed

Beniwal M, Bhat DI, Rao N, Bhagavatula ID, Somanna S (2015) Surgical management of petroclival meningiomas: factors affecting early post-operative outcome. Br J Neurosurg 2:1–6

Busso VO, McAuliffe JJ (2014) Intraoperative neurophysiological monitoring in pediatric neurosurgery. Paediatr Anaesth 24(7):690–697PubMed

Cho CW, Al-Mefty O (2002) Combined petrosal approach to petroclival meningiomas. Neurosurgery 51(3):708–716 discussion 716-8PubMed

Colletti V, Fiorino FG, Mocella S, Policante Z (1998) ECochG, CNAP and ABR monitoring during vestibular Schwannoma surgery. Audiology. 37(1):27–37PubMed

Colletti V, Fiorino FG, Carner M, Cumer G, Giarbini N, Sacchetto L (2000) Intraoperative monitoring for hearing preservation and restoration in acoustic neuroma surgery. Skull Base Surg 10(4):187–195PubMedPubMedCentral

Couldwell WT, Fukushima T, Giannotta SL, Weiss MH (1996) Petroclival meningiomas: surgical experience in 109 cases. J Neurosurg 84(1):20–28PubMed

10.

Cueva RA (2012) Preoperative, intraoperative, and postoperative auditory evaluation of patients with acoustic neuroma. Otolaryngol Clin N Am 45(2):285–290 vii

11.

Danner C, Cueva RA (2004) Extended middle fossa approach to the petroclival junction and anterior cerebellopontine angle. Otol Neurotol 25(5):762–768PubMed

12.

Ebner FH, Koerbel A, Roser F, Hirt B, Tatagiba M (2009) Microsurgical and endoscopic anatomy of the retrosigmoid intradural suprameatal approach to lesions extending from the posterior fossa to the central skull base. Skull Base 19(5):319–323PubMedPubMedCentral

13.

Ferber-Viart C, Laoust L, Boulud B, Duclaux R, Dubreuil C (2000) Acuteness of preoperative factors to predict hearing preservation in acoustic neuroma surgery. Laryngoscope. 110(1):145–150PubMed

14.

Gardner G, Robertson JH (1988) Hearing preservation in unilateral acoustic neuroma surgery. Ann Otol Rhinol Laryngol 97:55–66PubMed

15.

Hoa M, Drazin D, Hanna G, Schwartz MS, Lekovic GP (2012) The approach to the patient with incidentally diagnosed vestibular schwannoma. Neurosurg Focus 33(3):E2PubMed

16.

Hosmer DW, Jovanovic B, Lemeshow S (1989) Best subsets logistic-regression. Biometrics. 45(4):1265–1270

17.

Hunter JB, Weaver KD, Thompson RC, Wanna GB (2015) Petroclival meningiomas. Otolaryngol Clin N Am 48(3):477–490

18.

Ingelmo I, Trapero JG, Puig A, De Blas G, Regidor I, León JM (2003) Intraoperative monitoring of the facial nerve: anesthesia and neurophysiology considerations. Rev Esp Anestesiol Reanim 50(9):460–471PubMed

19.

Kim SM, Kim SH, Seo DW, Lee KW (2013) Intraoperative neurophysiologic monitoring: basic principles and recent update. J Korean Med Sci 28(9):1261–1269PubMedPubMedCentral

20.

Koerbel A, Kirschniak A, Ebner FH, Tatagiba M, Gharabaghi A (2009) The retrosigmoid intradural suprameatal approach to posterior cavernous sinus: microsurgical anatomy. Eur J Surg Oncol 35(4):368–372PubMed

21.

Lavrova SA, Leshchinskiĭ VG, Shershever AS, Iazov OA, Gerasimov MV (2005) Predictive value of intraoperative monitoring of brainstem acoustic evoked potentials during removal of parabrainstem tumors. Zh Vopr Neirokhir Im N N Burdenko 2:8–12 discussion 12

22.

Li D, Hao SY, Wang L, Tang J, Xiao XR, Zhou H, Jia GJ, Wu Z, Zhang LW, Zhang JT (2013) Surgical management and outcomes of petroclival meningiomas: a single-center case series of 259 patients. Acta Neurochir 155(8):1367–1383PubMed

23.

Little KM, Friedman AH, Sampson JH, Wanibuchi M, Fukushima T (2005) Surgical management of petroclival meningiomas: defining resection goals based on risk of neurological morbidity and tumor recurrence rates in 137 patients. Neurosurgery. 56(3):546–559 discussion 546-59PubMed

24.

Matthies C, Samii M (1997) Direct brainstem recording of auditory evoked potentials during vestibular schwannoma resection: nuclear BAEP recording. Technical note and preliminary results. J Neurosurg 86(6):1057–1062PubMed

25.

Matthies C, Samii M (1997) Management of vestibular schwannomas (acoustic neuromas): the value of neurophysiology for intraoperative monitoring of auditory function in 200 cases. Neurosurgery. 40(3):459–466 discussion 466-8PubMed

26.

Matthies C, Samii M (1997) Management of vestibular schwannomas (acoustic neuromas): the value of neurophysiology for evaluation and prediction of auditory function in 420 cases. Neurosurgery. 40(5):919–929 discussion 929-30PubMed

27.

Matthies C, Carvalho G, Tatagiba M, Lima M, Samii M (1996) Meningiomas of the cerebellopontine angle. Acta Neurochir Suppl 65:86–91PubMed

28.

Maurer AJ, Safavi-Abbasi S, Cheema AA, Glenn CA, Sughrue ME (2014) Management of petroclival meningiomas: a review of the development of current therapy. J Neurol Surg B Skull Base 75(5):358–367PubMedPubMedCentral

29.

Miyazaki H, Caye-Thomasen P (2018) Intraoperative auditory system monitoring. Adv Otorhinolaryngol 81:123–132PubMed

30.

Møller AR, Jho HD, Jannetta PJ (1994) Preservation of hearing in operations on acoustic tumors: an alternative to recording brain stem auditory evoked potentials. Neurosurgery. 34(4):688–692 discussion 92-3PubMed

31.

Moncho D, Poca MA, Minoves T, Ferré A, Rahnama K, Sahuquillo J (2013) Brainstem auditory evoked potentials and somatosensory evoked potentials in Chiari malformation. Rev Neurol 56(12):623–634PubMed

32.

Mura J, Cuevas JL, Rojas-Zalazar D, Riquelme F, Luna F, Sariego H, Marengo JJ (2015) Vestibular schwannomas: surgical treatment of 67 cases in 10 years. Neurocirugia (Astur)

33.

Nakamura M, Roser F, Mirzai S, Matthies C, Vorkapic P, Samii M (2004) Meningiomas of the internal auditory canal. Neurosurgery. 55(1):119–127 discussion 127-8PubMed

34.

Nakamura M, Roser F, Dormiani M, Matthies C, Vorkapic P, Samii M (2005) Facial and cochlear nerve function after surgery of cerebellopontine angle meningiomas. Neurosurgery. 57(1):77–90 discussion 77-90PubMed

35.

Nakamura M, Roser F, Dormiani M, Samii M, Matthies C (2005) Intraoperative auditory brainstem responses in patients with cerebellopontine angle meningiomas involving the inner auditory canal: analysis of the predictive value of the responses. J Neurosurg 102(4):637–642PubMed

36.

Nakatomi H, Miyazaki H, Tanaka M, Kin T, Yoshino M, Oyama H, Usui M, Moriyama H, Kojima H, Kaga K, Saito N (2015) Improved preservation of function during acoustic neuroma surgery. J Neurosurg 122(1):24–33PubMed

37.

Nanda A, Javalkar V, Banerjee AD (2011) Petroclival meningiomas: study on outcomes, complications and recurrence rates. J Neurosurg 114(5):1268–1277PubMed

38.

Natarajan SK, Sekhar LN, Schessel D, Morita A (2007) Petroclival meningiomas: multimodality treatment and outcomes at long-term follow-up. Neurosurgery. 60(6):965–979 discussion 979-81PubMed

39.

Oh T, Nagasawa DT, Fong BM, Trang A, Gopen Q, Parsa AT, Yang I (2012) Intraoperative neuromonitoring techniques in the surgical management of acoustic neuromas. Neurosurg Focus 33(3):E6PubMed

40.

Ostreĭko LM, Khil’ko VA, Lytaev SA (1999) Monitoring of the auditory stem evoked potentials in removal of tumors of the posterior cranial fossa. Vestn Khir Im I I Grek 158(5):38–41PubMed

41.

Picton TW, Hillyard SA, Krausz HI, Galambos R (1974) Human auditory evoked potentials, I. Evaluation of components. Electroencephalogr Clin Neurophysiol 36(2):179–190PubMed

42.

Ramina R, Mattei TA, Sória MG, da Silva EB Jr, Leal AG, Neto MC, Fernandes YB (2008) Surgical management of trigeminal schwannomas. Neurosurg Focus 25(6):E6 discussion E6PubMed

43.

Ramina R, Neto MC, Fernandes YB, Silva EB, Mattei TA, Aguiar PH (2008) Surgical removal of small petroclival meningiomas. Acta Neurochir 150(5):431–438 discussion 438-9PubMed

44.

Rampp S, Rensch L, Simmermacher S, Rahne T, Strauss C, Prell J (2017) Intraoperative auditory steady-state monitoring during surgery in the cerebellopontine angle for estimation of postoperative hearing classes. J Neurosurg 127(3):559–568PubMed

45.

Samii M, Gerganov VM (2011) Petroclival meningiomas: quo vadis? World Neurosurg 75(3–4):424PubMed

46.

Samii M, Matthies C (1997) Management of 1000 vestibular schwannomas (acoustic neuromas): the facial nerve – preservation and restitution of function. Neurosurgery. 40(4):684–694 discussion 694-5PubMed

47.

Samprón N, Altuna X, Armendáriz M, Urculo E (2014) Treatment of giant acoustic neuromas. Neurocirugia (Astur) 25(6):247–260

48.

Scheller C, Richter HP, Engelhardt M, Köenig R, Antoniadis G (2007) The influence of prophylactic vasoactive treatment on cochlear and facial nerve functions after vestibular schwannoma surgery: a prospective and open-label randomized pilot study. Neurosurgery. 61(1):92–97 discussion 97-8PubMed

49.

Schlake H-P, Milewski C, Goldbrunner R, Kindgen A, Riemann R, Helms J et al (2001) Combined intra-operative monitoring of hearing by means of auditory brainstem responses (ABR) and transtympanic electrocochleography (ECochG) during surgery of intra- and extrameatal acoustic neurinomas. Acta Neurochir 143(10):985–996PubMed

50.

Schramm J, Watanabe E, Strauss C, Fahlbusch R (1989) Neurophysiologic monitoring in posterior fossa surgery. I. Technical principles, applicability and limitations. Acta Neurochir 98(1–2):9–18PubMed

51.

Sohmer H, Feinmesser M (1967) Cochlear action potentials recorded from the external ear in man. Ann Otol Rhinol Laryngol. 76(2):427–435PubMed

52.

Tatagiba M, Roser F, Schuhmann MU, Ebner FH (2014) Vestibular schwannoma surgery via the retrosigmoid transmeatal approach. Acta Neurochir 156(2):421–425 discussion 425PubMed

53.

Tokimura H, Sugata S, Yamahata H, Yunoue S, Hanaya R, Arita K (2014 Oct) Intraoperative continuous monitoring of facial motor evoked potentials in acoustic neuroma surgery. Neurosurg Rev 37(4):669–676PubMed

54.

Turel MK, Babu KS, Singh G, Chacko AG (2014) The utility of facial nerve amplitude and latency ratios in predicting postoperative facial nerve function after vestibular schwannoma surgery. Neurol India 62(2):178–182PubMed

55.

Turel MK, Thakar S, Rajshekhar V (2015 Feb) Quality of life following surgery for large and giant vestibular schwannomas: a prospective study. J Neurosurg 122(2):303–311PubMed

56.

Velho V, Agarwal V, Mally R, Palande DA (2012) Posterior fossa meningioma “our experience” in 64 cases. Asian J Neurosurg 7(3):116–124PubMedPubMedCentral

57.

Watanabe E, Schramm J, Strauss C, Fahlbusch R (1989) Neurophysiologic monitoring in posterior fossa surgery. II. BAEP-waves I and V and preservation of hearing. Acta Neurochir 98(3–4):118–128PubMed

58.

Xing HS, Wang SX, Wang Z, Cao PC, Ma YQ, Wang ZW (2014) Protection of facial nerves during acoustic neuroma surgery. Cell Biochem Biophys

59.

Xu F, Karampelas I, Megerian CA, Selman WR, Bambakidis NC (2013) Petroclival meningiomas: an update on surgical approaches, decision making, and treatment results. Neurosurg Focus 35(6):E11PubMed

60.

Yamakami I, Yoshinori H, Saeki N, Wada M, Oka N (2009) Hearing preservation and intraoperative auditory brainstem response and cochlear nerve compound action potential monitoring in the removal of small acoustic neurinoma via the retrosigmoid approach. J Neurol Neurosurg Psychiatry 80(2):218–227PubMed

61.

Yang I, Rutkowski MJ, Aranda D, Parsa AT (2010) Preservation of facial nerve function after resection of vestibular schwannoma. Br J Neurosurg 24(6):666–671PubMed

62.

Zaher A (2012) Visual and brainstem auditory evoked potentials in neurology, EMG methods for evaluating muscle and nerve function, Mr. Mark Schwartz (Ed.), ISBN: 978–953–307-793-2, InTech

Title: Electrophysiological predictors of hearing deterioration based on AEP monitoring during petroclival meningioma resection
Authors: Guilherme Lepski
Analía Arévalo
Florian Roser
M. Liebsch
Marcos Tatagiba
Publication date: 01-06-2021
Publisher: Springer Berlin Heidelberg
Keywords: Meningioma
Evoked Potential
Meningioma
Evoked Potential
Published in: Neurosurgical Review / Issue 3/2021
Print ISSN: 0344-5607
Electronic ISSN: 1437-2320
DOI: https://doi.org/10.1007/s10143-020-01350-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Electrophysiological predictors of hearing deterioration based on AEP monitoring during petroclival meningioma resection

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 3/2021

Atlanto-axial rotary instability (Fielding type 1): characteristic clinical and radiological findings, and treatment outcomes following alignment, fusion, and stabilization

Diagnostic impact of monitoring transcranial motor-evoked potentials to prevent ischemic complications during endovascular treatment for intracranial aneurysms

Intracranial anaplastic solitary fibrous tumor/hemangiopericytoma: immunohistochemical markers for definitive diagnosis

Retrospective application of risk scores to ruptured intracranial aneurysms: would they have predicted the risk of bleeding?

Comprehensive review of the mastoid foramen

Suprasellar arachnoid cysts in adults: clinical presentations, radiological features, and treatment outcomes