Intraoperative mapping and monitoring of sensory vagal fibers during vagal schwannoma resection

Laryngoscope. 2019 Dec;129(12):E434-E436. doi: 10.1002/lary.28147. Epub 2019 Jun 18.

Abstract

Vagal schwannomas are rare, benign tumors. Intermittent intraoperative neuromonitoring via selective stimulation of splayed motor fibers running on the schwannoma surface to elicit a compound muscle action potential has been previously reported as a method of preserving vagal motor fibers. In this case report, vagal sensory fibers are mapped and continuously monitored intraoperatively during high vagus schwannoma resection using the laryngeal adductor reflex (LAR). Mapping of nerve fibers on the schwannoma surface enabled identification of sensory fibers. Continuous LAR monitoring during schwannoma subcapsular microsurgical dissection enabled sensory (and motor) vagal fibers to be monitored in real time with excellent postoperative functional outcomes. Laryngoscope, 129:E434-E436, 2019.

Keywords: Neurolaryngology; neural monitoring; schwannoma; swallowing/dysphagia.

Publication types

  • Case Reports

MeSH terms

  • Cranial Nerve Neoplasms / diagnosis
  • Cranial Nerve Neoplasms / physiopathology
  • Cranial Nerve Neoplasms / surgery*
  • Female
  • Humans
  • Laryngoscopy
  • Magnetic Resonance Imaging
  • Middle Aged
  • Monitoring, Intraoperative / methods*
  • Nerve Fibers / pathology
  • Neurilemmoma / physiopathology
  • Neurilemmoma / surgery*
  • Otorhinolaryngologic Surgical Procedures / methods
  • Vagus Nerve Diseases / diagnosis
  • Vagus Nerve Diseases / physiopathology
  • Vagus Nerve Diseases / surgery*
  • Vagus Nerve*