caa a22 4500 606216804 CHVBK 20210128101105.0 cr unu---uuuuu 210128e20151101xx s 000 0 eng 10.1007/s00701-015-2518-1 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2518-1 Optional real-time display of intraoperative neurophysiological monitoring in the microscopic field of view: avoiding communication failures in the operating room [Elektronische Daten] [Veit Stoecklein, Florian Faber, Mandy Koch, Rudi Mattmüller, Anika Schaper, Frank Rudolph, Joerg Tonn, Christian Schichor] Background: The use of intraoperative neurophysiological monitoring (IONM) in neurosurgery has improved patient safety and outcomes. However, a pitfall in the use of IONM remains unsolved. Currently, there is no feasible way for surgeons to interpret IONM waves themselves during operations. Instead, they have to rely on verbal feedback from a neurophysiologist. This method is prone to communication failures, which can lead to delayed or false interpretation of the data. Direct visualization of IONM waves is a way to alleviate this problem and make IONM more effective. Methods: Microscope-integrated IONM (MI-IONM) was used in 163 cranial and spinal cases. We evaluated the feasibility, system stability and how well the system integrated into the surgical workflow. We used an IONM system that was connected to a surgical microscope. All IONM modalities used at our institution could be visualized as required, superimposed on the surgical field in the eyepiece of the microscope without obstructing the surgeon's field of vision. Results: Use of MI-IONM was safe and reliable. It furthermore provided valuable intraoperative information. The system merely required a short learning curve. Only minor system problems without impact on surgical workflow occurred. MI-IONM proved to be especially useful in surgical cases where careful monitoring of nerve function is required, e.g., cerebellopontine angle surgery. Here, direct assessment of surgical action and IONM wave change was provided to the surgeon, if necessary (on-off control). Conclusion: MI-IONM is a useful extension of conventional IONM that provides optional real-time functional information to the surgeon on demand. Springer-Verlag Wien, 2015 Intraoperative neurophysiological monitoring nationallicence Microscope integration nationallicence Acoustic neuroma nationallicence Stoecklein Veit Department of Neurosurgery, Ludwig-Maximilians-University, Marchioninistraße 15, 81377, Munich, Germany aut Faber Florian Department of Neurosurgery, Ludwig-Maximilians-University, Marchioninistraße 15, 81377, Munich, Germany aut Koch Mandy Department of Neurosurgery, Ludwig-Maximilians-University, Marchioninistraße 15, 81377, Munich, Germany aut Mattmüller Rudi Inomed Medizintechnik GmbH, Emmendingen, Germany aut Schaper Anika Inomed Medizintechnik GmbH, Emmendingen, Germany aut Rudolph Frank Carl Zeiss Meditec AG, Oberkochen, Germany aut Tonn Joerg Department of Neurosurgery, Ludwig-Maximilians-University, Marchioninistraße 15, 81377, Munich, Germany aut Schichor Christian Department of Neurosurgery, Ludwig-Maximilians-University, Marchioninistraße 15, 81377, Munich, Germany aut Acta Neurochirurgica Springer Vienna 157/11(2015-11-01), 1843-1847 0001-6268 157:11<1843 2015 157 701 https://doi.org/10.1007/s00701-015-2518-1 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 brief-communication jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2518-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Stoecklein Veit Department of Neurosurgery, Ludwig-Maximilians-University, Marchioninistraße 15, 81377, Munich, Germany aut NATIONALLICENCE 700 1- Faber Florian Department of Neurosurgery, Ludwig-Maximilians-University, Marchioninistraße 15, 81377, Munich, Germany aut NATIONALLICENCE 700 1- Koch Mandy Department of Neurosurgery, Ludwig-Maximilians-University, Marchioninistraße 15, 81377, Munich, Germany aut NATIONALLICENCE 700 1- Mattmüller Rudi Inomed Medizintechnik GmbH, Emmendingen, Germany aut NATIONALLICENCE 700 1- Schaper Anika Inomed Medizintechnik GmbH, Emmendingen, Germany aut NATIONALLICENCE 700 1- Rudolph Frank Carl Zeiss Meditec AG, Oberkochen, Germany aut NATIONALLICENCE 700 1- Tonn Joerg Department of Neurosurgery, Ludwig-Maximilians-University, Marchioninistraße 15, 81377, Munich, Germany aut NATIONALLICENCE 700 1- Schichor Christian Department of Neurosurgery, Ludwig-Maximilians-University, Marchioninistraße 15, 81377, Munich, Germany aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/11(2015-11-01), 1843-1847 0001-6268 157:11<1843 2015 157 701