Abstract
Continuous monitoring of wave V of auditory brainstem response (ABR), also called brainstem auditory evoked potential (BAEP), is the most common method used in intraoperative neuromonitoring (IONM) functionality of cochlear nerve during surgery in cerebellopontine angle (CPA). CE-Chirp® ABR represents a recent development of classical ABR. CE-Chirp® is a new acoustic stimulus used in newborn hearing testing, designed to provide enhanced neural synchronicity and faster detection of larger amplitude wave V. In four cases, CE-Chirp® ABR was performed during cerebellopontine angle (CPA) surgery. CE-Chirp® ABR represented a safe and effective method in neuromonitoring functionality of vestibulocochlear nerve. A faster neuromonitoring feedback to surgical equipe was possible with CE-Chirp ABR®.
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Acknowledgments
We express our sincere thanks to Laura Conti, Director of Unit of Neurophysiopathology of San Filippo Neri Hospital in Rome and to Nicola Stiacci, LeDiSo Italia srl, via Panciatichi, Firenze, Italian distriboutor of Interacoustics Eclipse EP15 ABR system, for tireless, comprehensive support.
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Apio Antunes, Porto Alegre, Brazil
Di Scipio and coworkers report a novel application of an already described technique for neuromonitoring during CP angle operations. The CE-CHIRP ABR monitoring system allows an easily detectable 4/5 waves modifications during the dissection moment of the operation, supposedly without the fading occurrence after repeated nerve stimulation. Originally described for hearing testing in pediatric patients, it is now applied during neurosurgical operations : it looks a very promising and easily detectable technique, and we certainly need a bigger series of patients to be sure it really allows precocious and reliable detection of excessive manipulation of CP angle nerves during the operation. We look forward for such a series!
Chang Jin Kim, Seoul, Korea
This is an interesting pilot study reporting a usefulness of CE-Chirp® ABR monitoring with feasible faster response than classical ABR in cerebellopontine angle surgery. Further comparative clinical studies are needed to validate this feature together with its efficacy and safety.
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Di Scipio, E., Mastronardi, L. CE-Chirp® ABR in cerebellopontine angle surgery neuromonitoring: technical assessment in four cases. Neurosurg Rev 38, 381–384 (2015). https://doi.org/10.1007/s10143-015-0609-3
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DOI: https://doi.org/10.1007/s10143-015-0609-3