Monitoring of corticobulbar motor evoked potentials during surgical remov¬al of brainstem and fourth ventricle tumors in pediatric patients

Abstract

Introduction. Corticobulbar motor evoked potentials (CB-MEP) are a modality of intraoperative monitoring (IOM) for assessment of the functional state of caudal cranial nerves. CB-MEPs can be used during fossa posterior surgery, when there is a risk of damaging the caudal cranial nerves and their nuclei. The possibility of using this modality in pediatric patients is rarely discussed in the literature. Objective. To assess the CB-MEP validity in the prognosis of neurological symptoms from caudal cranial nerves in the pediatric group of patients after surgery in the brainstem and fourth ventricle. Material and methods. The study included 30 children aged from 11 months to 17 years who underwent brainstem and the fourth ventricle tumor surgery with IOM at the N.N. Burdenko National Medical Research Center for Neurosurgery from January 2020 to November 2021. Results. We obtained statistically significant difference in the dynamics of the CB-MEP amplitude in the groups of patients with and without an increase in neurological symptoms (p<0.05). Conclusion. CB-MEP can be used during brainstem surgery in pediatric patients for assessing the functional state of caudal cranial nerves.