{
  "abstract": "Orbital and cranio-orbital lesions are often benign, but postoperative ocular misalignment or diplopia can impair the quality of life. Eye movement monitoring has mainly been used for intermittent mapping for localization; however, serial, stimulus-evoked surveillance with prompt alerts remains challenging. We report an initial consecutive case series evaluating feasibility, safety, and early outcomes of continuous, stimulus-evoked electro-oculography monitoring using repetitive direct stimulation through an electrode placed adjacent to the superior orbital fissure. We retrospectively reviewed 17 consecutive orbital and cranio-orbital lesion surgeries over 2 years. Continuous electro-oculography monitoring was attempted when superior orbital fissure access was allowed, using periocular recording electrodes and serial stimulation (typically 1 Hz) via a superior orbital fissure-adjacent stimulating electrode. Outcomes were assessed preoperatively and 3-9 months postoperatively, focusing on ocular motility deficits, diplopia, perioperative adverse events, and monitoring-related complications. Continuous electro-oculography monitoring was implemented in 9/17 cases (53%) and was feasible in all monitored cases, providing serial responses throughout lesion resection. Non-implementation reflected lack of superior orbital fissure access in endoscopic transnasal procedures (n = 5) or a supraorbital keyhole approach (n = 1), clinical non-necessity (n = 1), or absent evoked responses with complete preoperative palsy (n = 1). No trigeminocardiac reflex events or monitoring-related complications occurred. The exploratory final amplitude preservation ratio was ≥50% in all monitored cases. No monitored patient had postoperative worsening of ocular motility (0/9) or diplopia; one non-monitored patient experienced mild recurrent diplopia, improving on follow-up. Continuous superior orbital fissure-adjacent stimulation–evoked electro-oculography monitoring was feasible and safe when superior orbital fissure access was obtained and it provided serial eye movement surveillance signals in this initial consecutive case series.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ken MATSUSHIMA"
    },
    {
      "affs": [
        0
      ],
      "name": "Kyosuke MATSUNAGA"
    },
    {
      "affs": [
        0
      ],
      "name": "Nobuyuki NAKAJIMA"
    },
    {
      "affs": [
        0
      ],
      "name": "Michihiro KOHNO"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bdakc0jbaf455.bib",
  "cited_by": 0,
  "doi": "10.2176/jns-nmc.2026-0058",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13731975/",
  "id": "bdakc0jbaf455",
  "issns": [
    "0470-8105",
    "1349-8029"
  ],
  "landing_url": "https://doi.org/10.2176/jns-nmc.2026-0058",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2746|Intraoperative Neuromonitoring and Anesthetic Effects"
    ]
  ],
  "openalex": "W7211965941",
  "pdf_url": "https://www.jstage.jst.go.jp/article/nmc/advpub/0/advpub_2026-0058/_pdf",
  "pmcid": "PMC13731975",
  "pmid": "42716759",
  "published": "2026-09-09",
  "publisher": "Japan Neurosurgical Society",
  "ris": "https://research.draconitic.com/paper/bdakc0jbaf455.ris",
  "sources": [
    {
      "first_seen": "2026-11-08T12:22:03Z",
      "native_id": "PMC13731975",
      "source": "pmc",
      "url": "https://doi.org/10.2176/jns-nmc.2026-0058"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Intraoperative Neuromonitoring and Anesthetic Effects",
      "subfield": "surgery"
    }
  ],
  "title": "Continuous Eye Movement Monitoring via Superior Orbital Fissure Electrode Placement in Orbital and Cranio-orbital Lesion Surgery: An Initial Consecutive Case Series",
  "title_text": "Continuous Eye Movement Monitoring via Superior Orbital Fissure Electrode Placement in Orbital and Cranio-orbital Lesion Surgery: An Initial Consecutive Case Series",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:22:03Z",
  "url": "https://research.draconitic.com/paper/bdakc0jbaf455",
  "venue": "Neurologia medico-chirurgica",
  "versions": []
}