Neural conservation in skull base surgery

Surgical treatment of lesions of the skull base carries significant risk to the functioning of the cerebral hemispheres, brainstem, and cranial nerves. This risk is due to both (1) problems associated with maintaining an adequate blood flow while exposing and removing the tumor and (2) direct or indirect trauma to the brain, perineural tissues, and cranial nerves. These risks may be reduced if information about possible implications of surgical maneuvers on the cerebral blood flow and on the function of the patient’s CNS and cranial nerves is available and can be monitored during surgery of the skull base. The use of EMG neuromonitoring for the facial nerve and of brainstem evoked response …