@article{oai:hama-med.repo.nii.ac.jp:00000594,
 author = {杉山, 憲嗣 and 横山, 徹夫 and 龍, 浩志 and 難場, 宏樹},
 issue = {5},
 journal = {脳神経外科ジャーナル Japanese journal of neurosurgery},
 month = {May},
 note = {われわれが施行している第7〜第12脳神経に対する術中モニタリングを呈示した.これらの脳神経では, 第8脳神経以外は誘発筋電図によって術中モニタリングが可能であった.低電流, 単極刺激による術中誘発顔面筋電図では, 腫瘍摘出後に最中枢側の顔面神経刺激で得られた波形の振幅が術後の顔面機能に相関した.蝸牛神経の聴性脳幹反応による術中モニタリングでは, 術者への警告点を第5波の振幅の極端な低下, または消失とし, さらに蝸牛神経活動電位を脳槽部の聴神経内の蝸牛神経の部位同定に用いた.第9〜第12脳神経もそれぞれ誘発咽頭筋電図, 胸鎖乳突筋筋電図, 舌筋筋電図によりモニタリングが可能であったが, 術後機能との相関性に関してはさらに検討が必要と思われた.  Intraoperative monitoring methods of the lower cranial nerves (from the VII th nerve to the XII th nerve) were reviewed. All of the lower cranial nerves except the VIII th cranial nerve could be monitored intraoperatively using evoked muscle responses. It was essential to use low amplitude monopolar stimulation (less than 0.6mA) for obtaining adequate intraoperative evoked facial muscle response (EFMR). Postoperative facial function was correlated to the FEMR amplitude obtained with stimulation at most proximal sites of the facial nerve in the cerebello-pontine (CP) cistern after removal of the CP angle tumors. When the amplitude was more than 99 microvolts, the patient's facial functions was preserved. Auditory brainstem responses (ABR) were used for intraoperative cochlear nerve monitoring during microvascular decompression surgery for the VII th cranial nerve. As criteria for warning the surgeon, we adopted such changes as the disappearance or marked decrease in amplitude of the wave V. Cochlear nerve compound action potentials (CNAP) were also used for cochlear intraoperative monitoring. Cochlear nerves within the cisternal portion of the VIII th cranial nerve could be identified using CNAPs. CNAP had another advantage when cochlear function remained but could not be monitored by ABR in a case of CP angle tumor. The IX th and the X th cranial nerve functions could be monitored using evoked pharyngeal muscle response (EPMR). More studies are required to determine the precise relationship between EPMR and the IX th and the X th cranial nerve functions. Intraoperative lower cranial nerve monitorings has become am essential method to achieve greater safety and more successful outcomes in posterior fossa surgery.},
 pages = {330--338},
 title = {第7〜第12脳神経の術中モニタリング},
 volume = {10},
 year = {2001}
}