the art of neuromonitoring

in neuro and skull base surgery


Multimodal neuromonitoring in neuro and skull base surgery

Nearly all neurosurgical interventions in the head and neck area pose a risk to neural structures. Motor nerves, sensory nerves as well as cerebral structures such as certain areas in the brain may be injured in neurosurgical intervention. In order to identify and monitor the structures most at risk and their function, intraoperative neuromonitoring is often applied.


Multimodal neuromonitoring


Our AVALANCHE® SI neuromonitor has up to 8 channels and can measure various combinations of modalities so that the real-time status of various neural pathways can be assessed during surgery.


Motor cranial neural pathways can be monitored using EMG techniques. Stimulation is achieved through hand-held stimulation probes right at the operation site. The arising motor unit action potentials (MUAP) are picked up at the innervated target muscles and processed by the neuromonitor.


When operating on the ear and near the auditory nerve, measuring auditory evoked potentials (AEP) helps the surgeon to identify impaired function. Pre-defined clicking sounds are played to the patient via earphones. The action potentials thus triggered are picked up from the skull via needle electrodes. The AEP measurements provide an insight into the functionality of the auditory nerve (N. vestibulocochlearis) and the brain stem.

Stimulation probes

Electric stimulation of nerves and neuronal structures

The choice is yours: Bipolar or monopolar, conventional or minimally invasive, with or without microscope. Reusable or disposable accessories -

Our range offers a matching solution for virtually all situations.

Our stimulation probes have been made with special attention to ergonomics.

Quality made in Germany by Dr. Langer Medical.



Colour-coded needle electrodes for recording and stimulation

Whether one or several channels are required for the recording of EMG or EP signals or nerves and muscular tissue are to be stimulated, needle electrodes by Dr. Langer Medical GmbH will give you ample choice for neuromonitoring.

Various lengths, shapes and geometric arrangements as well as a palette of colours to suit your particular application purposes are available - the choice is yours.

Fields of application