Evidence map›Paper›PMID 41775377›Full record

ArticleJournal of clinical neurology (Seoul, Korea)2026

Intraoperative Visual Evoked Potential Monitoring in Endoscopic Endonasal Surgery for Nonpituitary Adenoma Suprasellar Tumors.

Young Nam Kwon, Hwa Reung Lee, Myung Jae Lee, Young Ung Kim, Seung Woo Kim, Ha Young Shin, Sung-Min Kim, Ju Hyung Moon, Jong Hee Chang, Eui Hyun Kim

Abstract read
In one paragraph

Article in Journal of clinical neurology (Seoul, Korea), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Young Nam KwonDepartment of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.ORCID https://orcid.org/0000-0002-3588-274X
Hwa Reung LeeDepartment of Neurology, Asan Medical Center, Seoul, Korea.ORCID https://orcid.org/0000-0002-5020-7662
Myung Jae LeeDepartment of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Young Ung KimDepartment of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Seung Woo KimDepartment of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.ORCID https://orcid.org/0000-0002-5621-0811
Ha Young ShinDepartment of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.ORCID https://orcid.org/0000-0002-4408-8265
Sung-Min KimDepartment of Neurology, Intraoperative Neurophysiological Monitoring Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.ORCID https://orcid.org/0000-0003-2425-6388
Ju Hyung MoonDepartment of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.ORCID https://orcid.org/0000-0002-8925-5821
Jong Hee ChangDepartment of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.ORCID https://orcid.org/0000-0003-1509-9800
Eui Hyun KimDepartment of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.ORCID https://orcid.org/0000-0002-2523-7122

Funding

Patient-Centered Clinical Research Coordinating Center RS-2025-02304254
6 · The paper itself

Abstract

background and purposeIntraoperative visual evoked potential (VEP) monitoring has been studied mainly in pituitary adenoma, while its role in nonpituitary suprasellar tumors has remained unclear. This study evaluated the predictive usefulness of intraoperative VEP monitoring during endoscopic endonasal surgery (EES) and aimed to identify optimal alarm criteria for visual outcomes.

methodsWe retrospectively analyzed a cohort of 87 patients who underwent EES with intraoperative VEP monitoring between April 2021 and September 2023. Visual outcomes were evaluated preoperatively and at short-term (≤3 months) and long-term (12 months) follow-ups, with visual deterioration at these time points defined as worsening of either visual acuity or the visual field. Reductions in the VEP amplitude were quantified using both the maximum intraoperative decrease and the final amplitude after recovery. Receiver operating characteristic (ROC) curve analyses were performed to identify the optimal alarm thresholds, and the sensitivity, specificity, positive predictive value, and negative predictive value were calculated for short-term and long-term visual deteriorations.

resultsShort-term and long-term visual deteriorations were detected in 12 (9.2%) and 5 (3.8%) of the 130 analyzed eyes, respectively. ROC curve analyses identified ≥40% and ≥30% reductions in the N75-P100 amplitude as optimal alarm criteria for short-term and long-term visual deteriorations, respectively. A 30% reduction without intraoperative recovery demonstrated markedly higher sensitivity than the conventional 50% alarm threshold for short-term (58.3% vs. 33.3%) and long-term (80.0% vs. 20.0%) outcomes, while maintaining acceptable specificity (82.2% and 80.8%, respectively).

conclusionsA 30% reduction in amplitude represents a more-sensitive and clinically relevant alarm threshold than a 50% reduction for intraoperative VEP monitoring during EES for nonpituitary suprasellar tumors. Incorporating both the magnitude and recovery pattern of VEP amplitude changes may improve the accuracy of predictions of long-term visual deterioration. However, the potential for false positives warrants cautious interpretation, and further studies are needed to validate the impact of intraoperative VEP monitoring on visual outcomes.

Indexed as

endoscopic endonasal surgeryintraoperative neurophysiological monitoringoptic nervesuprasellar tumorvisual evoked potential

Identifiers

PMID41775377
PMCPMC12956457

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.