Intraoperative Monitoring (IOM)
Intraoperative Monitoring (IOM) Overview
Intraoperative monitoring (IOM) encompasses a number of neurophysiologic modalities commonly used in outpatient and hospital settings to study and assess the function of the nervous system. These tests include:
- Electroencephalography (EEG)
- Electromyography (EMG)
- Evoked potentials (EPs)
- Nerve conduction velocity (NCV)
Some unique techniques, such as transcranial electrical motor evoked potentials (tceMEPs) and intracranial functional mapping (ECoG), are also included in the IOM tool kit. The history of IOM dates back to using EEG during brain surgeries in the first half of the twentieth century. The successive decades saw the incorporation of other clinical neurophysiological modalities into the operative room settings.
What is IOM used for?
The main aim of IOM is to warn the surgeon of a severe impending complication in time to intervene and prevent a lasting or permanent injury to the central and peripheral nervous system. IOM can also help to identify a serious systemic problem, such as metabolic derangements, hypoperfusion, and hypothermia. Surgeons assisted by IOM can perform a more precise resection with a greater safety margin than would be impossible with anatomical knowledge and personal expertise alone.
In short, using IOM allows neurosurgeons to proceed with surgery for high-risk patients who might otherwise be turned away.
About the Barrow IOM
Barrow Neurological Institute has a bustling IOM program with 13 full-time IOM technologists covering 11 operating rooms and three interventional radiology suites. On average, we monitor over 3,000 surgical cases in a given year. We routinely implement new and innovative technologies and techniques developed in our institution and in other academic centers.
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