Utilization of Intraoperative Continuous Flash Visual Evoked Potentials in Endoscopic Skull Base Surgery
Bibliographic record
Abstract
Objective: Minimally invasive endoscopic endonasal skull base surgery offer safer and more effective access to the skull base to remove benign and malignant tumors. However, endoscopic skull base surgery around the visual pathway may increase the risk of injury of the visual pathway. Monitoring of flash visual evoked potentials (FVEPs) during surgery may detect a possible injury to the visual pathway, allowing the surgeon to take corrective measures during surgery to reverse or minimize it. The purpose of this study is to determine whether monitoring FVEPs during brain surgery can predict, prevent or minimize visual pathway injury. Methods: We identified patients with chiasmatic or prechiasmatic lesions who underwent minimally invasive endoscopic skull base surgery. Patients were subjected to eye exam (color vision, visual acuity, and visual field evaluation) within 3 months before surgery, and within 6 to 12 weeks and 6 to 9 months after surgery to explore short- and long-term surgical outcomes on eyesight. During surgery, FVEPs were recorded from electrodes placed in the scalp overlying the visual cortex after flashing red light stimulation (Cadwell LED stimulating goggles), as reported previously. We examined the relationship between FVEPs amplitude change and visual outcome on these patients. Results: A total of 102 patients have been enrolled in this retrospective study. The median age at admission was 57 years (range: 22–86 years) and 68.4% of the patients were female. Most of the patients had either pituitary adenoma (64.7%) or skull base meningioma (23.5%). Preliminary eye evaluations (pre- and postsurgery) showed that the patients did not develop short- or long-term eyesight impairments. Conclusion: Our study provides a new method for rapidly acquiring reproducible FVEP waves for which allows for timely reporting significant FVEP changes resulting in prompt signal action. Thus, monitoring FVEPs during endoscopic endonasal skull base surgery reduces the risk of visual pathway injury. Publication History Article published online: 15 February 2022 © 2022. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".