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Intraoperative neurophysiological monitoring

Neuromonitoring Techniques: – Electrophysiologic modalities used in intraoperative neurophysiological monitoring include extracellular recordings, SSEP, TCeMEP, EEG, EMG, and ABR. – Transcranial Doppler imaging is utilized […]

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Neuromonitoring Techniques:
– Electrophysiologic modalities used in intraoperative neurophysiological monitoring include extracellular recordings, SSEP, TCeMEP, EEG, EMG, and ABR.
– Transcranial Doppler imaging is utilized to detect vascular emboli.
– Techniques like SSEP monitor spinal cord function, TCeMEP monitor spinal cord activity, and EEG monitor cerebral function and tumor margins.

Certification and Licensure:
– In the US, legislation for IONM licensure is absent.
– Private certifications like CNIM and D.ABNM are available globally.
– CNIM requirements include specific credentials and a minimum number of surgeries.
– Audiologists can achieve board certification in neurophysiological intraoperative monitoring.

Applications in Surgery:
– Intraoperative neurophysiological monitoring is commonly used in spinal surgery, brain surgeries, carotid endarterectomy, ENT procedures, and nerve surgeries.
– It plays a crucial role in enhancing surgical precision and reducing the risk of neurological damage during high-risk procedures.

Role of Neurophysiologist:
– Neurophysiologists monitor patient neurological responses during surgery.
– They alert the surgical team to any changes in signals and adjust anesthetic depth if necessary.
– Neurophysiologists work closely with the surgical team and provide detailed reports post-surgery.

Benefits for Patients:
– Intraoperative neurophysiological monitoring reduces the risk of postoperative neurological deficits and complications.
– It leads to shorter hospital stays, improved surgical outcomes, and increased patient satisfaction.
– The technique enhances safety during high-risk procedures and provides real-time feedback to the surgical team.

Intraoperative neurophysiological monitoring (Wikipedia)

Intraoperative neurophysiological monitoring (IONM) or intraoperative neuromonitoring is the use of electrophysiological methods such as electroencephalography (EEG), electromyography (EMG), and evoked potentials to monitor the functional integrity of certain neural structures (e.g., nerves, spinal cord and parts of the brain) during surgery. The purpose of IONM is to reduce the risk to the patient of iatrogenic damage to the nervous system, and/or to provide functional guidance to the surgeon and anesthesiologist.

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