The value of intraoperative neuromonitoring combined with high-definition endoscopy in the operation of brachial plexus schwannoma

Background To investigate the value of intraoperative neuromonitoring (IONM) combined with high-definition endoscopy in surgical treatment of brachial plexus schwannoma. Methods A retrospective analysis was conducted on twenty patients diagnosed with brachial plexus schwannoma from January 2020 to December 2024. All cases were treated surgically with IONM combined with high-definition endoscopy. Intraoperative and postoperative nerve function were assessed to evaluate the value of this combined approach during surgery. Results All twenty patients underwent complete intracapsular tumor resection. Two patients developed numbness in the fingers, and one patient developed numbness in the shoulder. Postoperative motor function was unaffected in all patients. No tumor recurrence was observed during a follow-up period from one to four years. Conclusion IONM combined with high-definition endoscopy helps to better identify nerve trajectories, plan tumor envelope incision pathways, detect early nerve injuries and assess the prognosis of nerve conduction function. This procedure also contributes to improving patient's quality of life.