Key result
Intraoperative NIRS detects no significant drop in cerebral oxygenation during pediatric carotid neuroblastoma excision.
Why the study?
Though NIRS is regularly used in pediatric cardiac surgeries to monitor cerebral oxygenation, its use in pediatric head and neck surgeries as a surrogate for cerebral perfusion requires further emphasis.
Case Report (n=1)
No
NIRS monitoring may be a useful surrogate for cerebral perfusion during pediatric head and neck surgeries to ensure uninterrupted cerebral circulation.
Hypothesis-generating for NIRS in rare pediatric head-neck cases; prospective studies needed before any clinical adoption.
Near-infrared spectroscopy (NIRS) is a noninvasive monitor used regularly in pediatric cardiac surgeries to monitor regional cerebral oxygenation (rScO2). A significant intraoperative cerebral desaturation (>20% from baseline) has been reported with poor neurological outcomes. We describe a case of a six-year-old child with carotid sheath neuroblastoma, located at the carotid bifurcation posted for tumor excision. Intraoperative NIRS monitoring revealed only a transient and insignificant (<10%) fall in the rScO2 during the tumor manipulation, ensuring uninterrupted cerebral circulation. The pediatric population is vulnerable to various physiological changes during anesthesia and surgery, and conserving cerebral function is one of the major goals. Though NIRS has been researched in various surgical specialties, future emphasis must be laid on its use in pediatric head and neck surgeries as a surrogate for cerebral perfusion.
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Ramadurai et al. (2024) conducted a case report in Carotid sheath neuroblastoma (n=1). Near-infrared spectroscopy (NIRS) monitoring was evaluated on Regional cerebral oxygenation (rScO2). Intraoperative NIRS monitoring during pediatric carotid sheath neuroblastoma excision detected only a transient, insignificant (<10%) fall in regional cerebral oxygenation during tumor manipulation.
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