Intraoperative monitoring of olfactory function: a feasibility study.

Authors:
Shahan Momjian
Shahan Momjian
Addenbrooke's Hospital
United Kingdom
Remi Tyrand
Remi Tyrand
University Hospital Geneva
Switzerland
Basile N Landis
Basile N Landis
University of Dresden Medical School
Germany
Colette Boex
Colette Boex
University Hospital of Geneva
Geneva | United States

J Neurosurg 2019 Apr 19:1-6. Epub 2019 Apr 19.

2Faculty of Medicine, University of Geneva, Switzerland.

OBJECTIVEIntraoperative neuromonitoring of the chemical senses (smell and taste) has never been performed. The objective of this study was to determine if olfactory-evoked potentials could be obtained intraoperatively under general anesthesia.METHODSA standard olfactometer was used in the surgical theater with hydrogen sulfide (4 ppm, 200 msec). Olfactory-evoked potentials were recorded in 8 patients who underwent neurosurgery for resection of cerebral lesions. These patients underwent routine target-controlled propofol and sufentanil general anesthesia. Frontal, temporal, and parietal scalp subdermal electrodes were recorded ipsilaterally and contralaterally at the site of the surgery. Evoked potentials were computed if at least 70 epochs (0.5-100 Hz) satisfying the artifact rejection criterion (threshold 45 μV) could be extracted from signals of electrodes.RESULTSContributive recordings were obtained for 5 of 8 patients (3 patients had fewer than 70 epochs with an amplitude < 45 μV). Olfactory-evoked potentials showed N1 responses (mean 442.8 ± 40.0 msec), most readily observed in the patient who underwent midline anterior fossa neurosurgery. No component of later latencies could be recorded consistently.CONCLUSIONSThe study confirms that olfactory-evoked potentials can be measured in response to olfactory stimuli under general anesthesia. This demonstrates the feasibility of recording olfactory function intraoperatively and opens the potential for neuromonitoring of olfactory function during neurosurgery.

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Source
https://thejns.org/view/journals/j-neurosurg/aop/article-10.
Publisher Site
http://dx.doi.org/10.3171/2019.1.JNS182731DOI Listing
April 2019
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