대한임상검사과학회지 (Korean Journal of Clinical Laboratory Science)

  • 제48권3호
  • /
  • Pages.262-268
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  • 2016
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  • 1738-3544(pISSN)
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  • 2288-1662(eISSN)
대한임상검사과학회 (Korean Society for Clinical Laboratory Science)
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편측성 안면경련 환자의 미세혈관 감압수술에서 효과적인 수술 중 신경계 감시검사를 위한 제안

Suggestions for the Effective Intraoperative Neurophysiological Monitoring in Microvascular Decompression Surgery of Hemifacial Spasm

  • 투고 : 2016.06.23
  • 심사 : 2016.08.05
  • 발행 : 2016.09.30
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초록

편측성 안면경련(hemifacial spasm)은 불수의적으로 안면의 근육에서 발작적인 경련이 일측성으로 반복해서 발생하는 질환이다. 한 근육의 수축으로 인해 동시적으로 여러 근육이 동시에 수축되는 동시 수축성(synkinesia)이 특징이다. 발병원인은 제 7뇌신경인 안면신경이 혈관에 의해 압박을 받아서 나타나게 된다. 본 연구는 편측성 안면경련 환자의 미세혈관 감압 수술을 받은 환자를 대상으로 수술 중 진행되는 신경계 감시검사 방법들에 대해 다루었다. 청각유발전위 검사에서는 수술용 뇌 견인기의 사용시 주의 사항과 검사시기에 대해 언급하였다. 안면신경의 근전도검사에서는 잡파의 혼입과 신경손상 시 근전도 파형의 감별에 대해, 측면전파 반응 검사에서는 마취의 유지의 중요성에 대해 그리고 체성감각 유발전위검사에서는 환자를 좀더 자세하게 검사할 수 있도록 새로운 방법을 제안하였다. 위에 언급한 내용들을 토대로 검사한다면 수술 중 신경계 감시 검사를 원활하게 할 수 있으리라 생각된다.

Hemifacial spasm is a disease caused by involuntary facial muscles with repeated unilateral convulsive spasms. It involves contraction of multiple muscles at the same time (synkinesia). The pathogenesis appears to be the pressure on the vessel by the facial nerve. This study included hemifacial spasm patients, who received microvascular decompression surgery. Brainstem auditory evoked potential and the examination time were carefully noted when using brain surgical retractor. The facial nerve electromyography tests for the identification of artifacts and EMG waveform when the facial nerve damage, about the importance of the maintenance of anesthesia in the lateral spread response and in a somatosensory evoked potential propose a new method. Based on the above test, it will be more effective.

키워드

참고문헌

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피인용 문헌

  1. 손목터널증후군 진단 시 F파의 유용성에 관한 연구 vol.18, pp.10, 2017, https://doi.org/10.5762/kais.2017.18.10.290
  2. 수술 중 신경계감시검사에서 검사에 따른 전극의 삽입 및 제거방법 vol.51, pp.4, 2016, https://doi.org/10.15324/kjcls.2019.51.4.453