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  • Title: Neurophysiological intraoperative monitoring of the glossopharyngeal nerve: technical case report.
    Author: Husain AM, Wright DR, Stolp BW, Friedman AH, Keifer JC.
    Journal: Neurosurgery; 2008 Oct; 63(4 Suppl 2):277-8; discussion 278. PubMed ID: 18981820.
    Abstract:
    OBJECTIVE: Neurophysiological intraoperative monitoring of the glossopharyngeal nerve has been performed only with needle electrodes inserted into the pharyngeal muscles or soft palate. We describe a noninvasive method of monitoring this cranial nerve. METHODS: A 30-year-old man who presented with headache, as well as speech and swallowing difficulty, underwent surgical resection of a right vagus nerve schwannoma. Neurophysiological intraoperative monitoring of multiple lower cranial nerves, including the glossopharyngeal and vagus nerves, was performed. RESULTS: The glossopharyngeal nerve was monitored with an adhesive surface electrode mounted on the cuff of a laryngeal mask airway, and the vagus nerve was monitored with a similar electrode mounted on the endotracheal tube. Successful monitoring allowed separation of the glossopharyngeal nerve from the tumor, and there was no postoperative swallowing deficit. CONCLUSION: Monitoring of the glossopharyngeal nerve with surface electrodes is possible and reliable, but it must be combined with vagus nerve monitoring.
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