Neurosurgery and neurotology involves the treatment of pathologies such as “primary” tumours of the central nervous system (glioma and meningioma), anterior fossa, cerebellopontine angle tumours or intracranial nerves (schwannoma). These Surgeries require an IntraOperative neurostimulator or NeuroMonitoring (IONM) medical device support, in order to protect nerves integrity, functional and cognitive function of the patient.
Application: low grade glioma resection. Cortex mapping during awake brain surgery for glioma resection is intended to preserve motor, linguistic, visual, spatial, calculative… functions of the patient. This surgery is facilitated by the use of a bipolar « Y » shaped stimulation probe (CE Mark ongoing) to transiently disrupt a targeted area. The patient’s response to this disruption allows to locate functional areas to preserve during resection.
The use of ElectroMyoGraphy (EMG) monitoring is essential during skull base tumour resection owing to the presence of cranial nerves. Stimulation with a monopolar probe will allow the location of a nerve through tissue, whereas a bipolar probe will provide a refined search for a targeted nerve.
Application: vestibular Schwannoma resection. This surgery is performed with cranial nerve parameters from monitoring mode. It allows to monitor the vocal cords through an electrode situated on the laryngeal tube and Frontalis, Orbicularis Oculi, Orbicularis Oris, Mentalis muscles through EMG needles.