APPLICATION OF SHOT-LATENCY SOMATO-SENSORY EVOKED POTENTIALS FOR EVALUATION
OF SWALLOWING DISORDERS IN EARLY PERIOD AFTER POSTERIOR FOSSA SURGERY
Podlepich V.V., Savin I.A., Goryachev A.S., Oshorov A.V., Szymanski V.N., Madorsky S.V., Sokolova
E.Yu., Matskovsky I.V., Ananiev E.P., Nichaeva A.G.
Burdenko Scientific Research Institute of Neurosurgery of the Russian Academy of Medical Sciences,
Moscow, Russia
correspondence to: Podlepich Vitaly Vyacheslavovich
e-mail:
vpodlepich@nsi.ru
Abstract:
Main tasks of early postoperative period in patients after posterior fossa surgery are the timely and
safe weaning from mechanical ventilation and extubation. For clinical assessment of the hypopharynx
function we use an algorithm developed in the intensive care unit (ICU) of the Burdenko Scientific Research
Institute of Neurosurgery. Disadvantages of the clinical test for assessment of patient’s readiness for
extubation are subjectivity and impossibility to use it in conditions of even superficial sedation. Shot-latency
somato-sensory evoked potentials (SSEP) can be applied in conditions of sedation and objectify the brain
stem deficit. The goal of the study was to define the changes of cortical SSEP in patients with disorders of
swallowing after posterior fossa surgery. To assess the swallowing disorders we used a scale of swallowing
disorders in intubated patients with brain stem damage. We compared results of cortical SSEP, test of
swallowing disorders in intubated patients and clinical results of extubation. 17 patients with tumors of
posterior fossa were included in the study. All patients were divided into two groups depending on duration of
mechanical ventilation. Patients of the group-1 were successfully extubated in 4.5 hours. Patients of the
group-2 were mechanically ventilated more than 15 hours because of impossibility to pass the test of
readiness for extubation. Results:
С
entral conduction time symmetry index after the surgery was lower in the
group-1 than in group-2. There was inverse correlation between amplitude of cortical response N20 and time
from the patient's admission to the ICU until the moment of extubation. Conclusions: asymmetry of central
conduction time and decreasing of N20 amplitude can be used as additional predictor of swallowing disorder.
Key words:
somato-sensory evoked potentials, SSEP, central conduction time, swallowing disorder,
posterior fossa, neuro-resuscitation
AN-1401-052
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