OBJECTIVE: Lower cranial nerve palsy is one of the most critical complications after posterior fossa surgery. However, no established monitoring procedures exist for glossopharyngeal nerve function. Therefore, glossopharyngeal nerve evoked potentials after stimulation of the posterior part of the tongue in dogs was studied to analyze whether glossopharyngeal nerve compound action potentials and evoked potentials are useful in the intraoperative monitoring of patients undergoing brainstem and cerebellopontine angle surgery. METHODS: Glossopharyngeal nerve action potentials and cortical potentials were evoked by stimulating the posterior part of the tongue in mongrel dogs. The potentials were evoked by supramaximal constant current electrical stimuli delivered with bipolar stainless steel needle electrodes and recorded with silver ball electrodes. RESULTS: Compound nerve action potentials were recorded from the exposed intracranial portion of the glossopharyngeal nerve. The latency of the initial negative peak of the action potentials was 2.8 ± 0.6 milliseconds (mean ± standard deviation; n = 17). Evoked cortical potentials were recorded on the coronal gyrus by stimulating the contralateral side. The latencies of the initial positive peak and negative peak were 20.1 ± 3.7 and 35.7 ± 8.2 milliseconds, respectively (n = 6). Ipsilateral tongue stimulation elicited biphasic evoked potentials on the coronal gyrus, which had small amplitudes and delayed latencies. Both compound nerve action potentials and cortical evoked potentials disappeared after sectioning of the glossopharyngeal nerve. CONCLUSION: The glossopharyngeal nerve action potentials and cortical potentials elicited by the stimulation of the posterior one-third of the tongue can be recorded. These evoked potentials represent a new means for intraoperative monitoring of patients undergoing surgery in the brainstem via the cerebellopontine angle, which involves the lower cranial nerves.
- Compound action potentials
- Glossopharyngeal nerve
- Somatosensory evoked potentials
ASJC Scopus subject areas
- Clinical Neurology