A nerve stimulator for the cerebellopontine angle Technical note
CHARLES W. MORCAN, M . A . , AND PETER J. JANNETTA, M . D .
University of Pittsburgh, Pittsburgh, Pennsylvania A fine-tipped bipolar nerve-stimulator probe has been developed and has proved especially useful in intracranial surgery of the cranial nerves. KEY WORDS 9 nerve-stimulator probe instrumentation
OMMERCIALLY available nerve stimulators, although suitable for gross peripheral nerve work, are constructed in such proportions that precise placement in an area of limited exposure is difficult and frequently impossible. We have devised a probe of proper length, slimness, angulation, and versatility that allows precise placement in the cerebellopontine angle for identification of nerves for stimulation or recording and for microsurgical procedures in peripheral nerve problems.
c
Technical Description
The nerve-stimt~lating probe is a lightweight instrument, weighing about 1/3 oz, with a bayonet-shaped plexiglass handle 1/4 in. in diameter. The handle is 63/4 in. long, with a single 30 ~ bend that allows the surgeon's hand to drop out of the microscope field of 688
9 cranial nerves
9
view (Fig. 1 upper). The bipolar probes are malleable stainless steel or brass wire, .021 in. in diameter (the size of the stylus in a No. 20 spinal needle). They are entirely insulated with Insl-x* except for 1 mm at the tips (Fig. 1 lower), and extend 3 in. beyond the plexiglass handle. The stimulating wires are easily molded into any position during surgery for better access to the nerve. These wires are imbedded in dental cement in the tip of the handle and are connected to 28 A W G (American Wire Gauge) Teflon-coated flexible wires that extend out of the rear of the handle for about 36 in. The light wires are pinned to the drapes near the surgical field and permit delicate control of the stimulating probe. These light wires are then connected through a Jones plug *Insl-x is made by Insl-x Products Corporation, Yonkers, New York.
J. Neurosurg. / Volume 46 / May, 1977
Nerve stimulator
FIG. 1. Upper." Bipolar nerve-stimulating probe with light, flexible connecting wires and male Jones plug. Lower." Close-up view of the uninsulated stimulator tips of the probe. to a heavier extension cord (18 A W G appliance cord) that attaches to the nerve stimulator. The nerve-stimulator probe is easily adapted to any bipolar stimulator. The probe must be gas sterilized.
J. Neurosurg. / Volume 46 / May, 1977
Address reprint requests to: Peter J. Jannetta, M.D., Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania 15213.
689
CHARLES W. MORCAN, M . A . , AND PETER J. JANNETTA, M . D .
University of Pittsburgh, Pittsburgh, Pennsylvania A fine-tipped bipolar nerve-stimulator probe has been developed and has proved especially useful in intracranial surgery of the cranial nerves. KEY WORDS 9 nerve-stimulator probe instrumentation
OMMERCIALLY available nerve stimulators, although suitable for gross peripheral nerve work, are constructed in such proportions that precise placement in an area of limited exposure is difficult and frequently impossible. We have devised a probe of proper length, slimness, angulation, and versatility that allows precise placement in the cerebellopontine angle for identification of nerves for stimulation or recording and for microsurgical procedures in peripheral nerve problems.
c
Technical Description
The nerve-stimt~lating probe is a lightweight instrument, weighing about 1/3 oz, with a bayonet-shaped plexiglass handle 1/4 in. in diameter. The handle is 63/4 in. long, with a single 30 ~ bend that allows the surgeon's hand to drop out of the microscope field of 688
9 cranial nerves
9
view (Fig. 1 upper). The bipolar probes are malleable stainless steel or brass wire, .021 in. in diameter (the size of the stylus in a No. 20 spinal needle). They are entirely insulated with Insl-x* except for 1 mm at the tips (Fig. 1 lower), and extend 3 in. beyond the plexiglass handle. The stimulating wires are easily molded into any position during surgery for better access to the nerve. These wires are imbedded in dental cement in the tip of the handle and are connected to 28 A W G (American Wire Gauge) Teflon-coated flexible wires that extend out of the rear of the handle for about 36 in. The light wires are pinned to the drapes near the surgical field and permit delicate control of the stimulating probe. These light wires are then connected through a Jones plug *Insl-x is made by Insl-x Products Corporation, Yonkers, New York.
J. Neurosurg. / Volume 46 / May, 1977
Nerve stimulator
FIG. 1. Upper." Bipolar nerve-stimulating probe with light, flexible connecting wires and male Jones plug. Lower." Close-up view of the uninsulated stimulator tips of the probe. to a heavier extension cord (18 A W G appliance cord) that attaches to the nerve stimulator. The nerve-stimulator probe is easily adapted to any bipolar stimulator. The probe must be gas sterilized.
J. Neurosurg. / Volume 46 / May, 1977
Address reprint requests to: Peter J. Jannetta, M.D., Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania 15213.
689
