Intraoperative Monitoring Of Neural Function

This second edition devotes almost 1000 pages to IOM. The first section covers basic science aspects to understand the generation of electro-physiologic signals and the anatomic structures involved. Then it follows a detailed description of ALL the techniques currently available. The last part covers the different types of surgical procedures where IOM may be needed

Intraoperative Neuromonitoring takes you step by step through the proper protocols for measuring and mapping neural function, emphasizing the correct application of intraoperative recordings for improved surgical outcomes. You will learn how to utilize the very latest neuromonitoring tools, and familiarize yourself with the full range of topics pertaining to intraoperative monitoring in neurosurgery. The authors also present both common and lesser-known techniques for neural assessment, resulting in a stand-alone reference that helps you master any type of neuromonitoring for virtually every kind of procedure. The most complete, expert-authored intraoperative neuromonitoring resource, addressing the most current topics, tools, and techniques to enhance your skills. Logical five-part organization clearly explains must-know topics such as neuromonitoring during cerebrovascular surgery, mapping cerebral and brainstem function, neuromonitoring in spinal surgery peripheral nerve procedures, and more.

The third edition of this classic text again provides practical, comprehensive coverage of the anatomical and physiological basis for intraoperative neurophysiological monitoring. Written by a leading authority in the field, Dr. Aage Moller has updated this important title to again offer all the leading-edge knowledge needed to perform electrophysiological recordings in the operating room, to interpret the results, and to present the results to the surgeon. The field known as "intraoperative monitoring" has expanded rapidly to cover other uses of neurophysiology and electrophysiologic recordings during surgical operations that affect the brain, spinal cord, and other parts of the nervous system. These new areas are covered in this new edition. To better represent the content of the book and the field as it now stands, many of the chapters have been revised and new material has been added. While the general organization of the book is maintained, chapters such as monitoring of motor systems have been revised and extended with new material, including more detailed description of the anatomy and physiology of motor systems and new information about intraoperative monitoring.

Intra-operative neuromonitoring (IONM) refers to a diverse and evolving collection of techniques used to provide real-time assurance of neurological integrity during surgery. Most frequently utilised during neurosurgical procedures, the use of IONM has increased dramatically over recent years, and there is an ongoing need for structured and accessible information in its principles, implementation and interpretation. This dynamic book provides a practical overview of IONM, in simple language and clearly illustrated. Uniquely, it is authored by experienced multidisciplinary clinicians affiliated to Kingâ (TM)s College Hospital NHS Foundation Trust, a regional neurosciences centre in London, UK. Combining the expertise of anaesthetists, physiologists, surgeons and patients themselves, this guide represents an invaluable source of information for all staff and trainees involved in the pre-, intra- and postoperative care of patients undergoing IONM.

Using narrative text, lists, tables, and illustrations, this handbook discusses all practical aspects of neurophysiologic intraoperative monitoring. Divided into two sections, the first part of the book introduces the “Basic Principles” with chapters on operating room setup, monitoring techniques and modalities, remote data acquisition, anesthesia, billing, ethical issues, and includes a buyer's guide to IOM machines which is invaluable for anyone setting up a laboratory. The second part, “Clinical Methods”, reviews the use of IOM in various types of surgeries. Each chapter is co-written by a neurophysiologist and technologist and presents a brief overview of the particular surgery, relevant anatomy and hardware, monitoring modalities, data interpretation and warning criteria, and technical considerations.

Intraoperative neurophysiologic monitoring has shown a steady increase in use for surgeries in which neural structures may be at risk of injury. Some of the surgical techniques used carry inherent risks, and these risks have changed the way in which neurophysiologic monitoring has impacted patient safety and quality of care during surgical procedures. It is therefore crucial that those performing and interpreting intraoperative neurophysiologic monitoring are adequately trained. This book is a comprehensive guide to the current practice of intraoperative neurophysiology with chapters on various modalities and clinical uses. Separate chapters devoted to anesthesia, operating room environment, special considerations in pediatrics and the interpretation and reporting of neurophysiologic data are useful and complementary. Questions and detailed answers on the topics covered can be found on the accompanying website for study review. This book will be useful to the trainee as well as the neurophysiologist already in practice.

The symposium from which this book originates represents a sig nificant watershed in the field of intraoperative neural monitoring, since the participants concluded that electrophysiologic monitoring techniques should be considered a "standard of care" for surgical pro cedures that place the central nervous system (CNS) at risk for injury. Specifically, it was agreed that the somatosensory-evoked potential (SEP) is a remarkably reliable and sensitive indicator of several aspects of CNS function, and should be routinely employed as an intraopera tive monitor during many neurosurgical and orthopedic procedures. The significance of this conclusion cannot be overstated, for at the time of this writing, intraoperative monitoring methods based on evoked-potential analyses are still considered experimental and are not in routine use. The reasons for this are not clear, given the accu mulation of literature and expertise on this subject over the past five years. Granted, the cost of electrophysiological monitoring equip ment is high, but only initially. The benefits of injury prevention far outweigh these costs, from both medical and economic viewpoints. It is our sincere hope and goal that the medical community be made aware of the value of intraoperative neural monitoring.

What is intraoperative neuropsyiological monitoring? How did this discipline evolve? Why is there a need for this clinical specialty? How does one function in the operating room? What are potential pitfalls and how does one resolve them? How does one get trained in intraoperative monitoring? These are just a few of the questions that arise when the term "intraoperative neuromonitoring" is mentioned. The purpose of this book is to provide satisfactory answers to these questions and more by addressing fundamental issues pertaining to intraoperative monitoring, in particular within the framework of clinical audiology. The focus is on neural functions that are most likely encountered by audiologists in conjunction with otology/neurotology and head-and-neck surgery operations, such as auditory function and motor cranial nerve function monitoring. While the facial nerve receives the most attention, other cranial nerves are also discussed in conjunction with certain operative procedures. The book includes descriptions of surgical procedures along with the appropriate neuromonitoring protocols. The author's hope is that the contents of this book will be instructive and that the book will engender sufficient interest and curiosity so that the reader will endeavor to seek additional information about this interesting, growing and clinically effective field. While this book is intended primarily for audiology students and practicing audiologists, its contents will be of assistance and interest to other health care providers seeking information about intraoperative monitoring.