• Riccardo Carrai, Francesca Morone, Fabrizio Baldanzi, Cristiana Martinelli, Camilla Bonaudo, Serena Tola, Giovanni Muscas, Riccardo Caramelli, Maddalena Spalletti, Antonello Grippo, Luca Bucciardini, Andrea Amadori, and Alessandro Della Puppa.
• SODc Neurophysiopathology, AOU Careggi, University Hospital, Florence, Italy.
• World Neurosurg. 2023 Oct 1; 178: e104e112e104-e112.

ObjectiveThe aim of the present study was to determine the position of the 3 sensory branches of the trigeminal nerve in the preganglionic tract using intraoperative neurophysiological mapping.MethodsWe included consecutive adult patients who underwent neurosurgical treatment of cerebellopontine angle lesions. The trigeminal nerve was antidromically stimulated at 3 sites along its circumference with different stimulus intensities at a distance of ≤1 cm from the brainstem. The sensory nerve action potentials (SNAPs) were recorded from each main trigeminal branch (V1 [ophthalmic branch], V2 [maxillary branch], and V3 [mandibular branch]).ResultsWe analyzed 13 patients. The stimulation points at which we obtained the greatest number of congruous and exclusive SNAPs (SNAPs only on the stimulated branch) was the stimulation point for V3 (20.7%). The stimulation intensity at which we obtained the highest number of congruent and exclusive SNAPs with the stimulated branch was 0.5 mA.ConclusionsUsing our recording conditions, trigeminal stimulation is a reliable technique for mapping the V3 and V1 branches using an intensity not exceeding 0.5. However, reliable identification of the fibers of V2 is more difficult. Stimulation of the trigeminal nerve can be a reliable technique to identify the V3 and V1 branches if rhizotomy of these branches is necessary.Copyright © 2023 Elsevier Inc. All rights reserved.

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