Identification and functional recording of the recurrent nerve by electrical stimulation during neck surgery

Hvidegaard, T.; Vase, P.; Jørgensen, Karsten; Blichert-Toft, M

doi:10.1288/00005537-198303000-00024

Cited by 13 publications

(3 citation statements)

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“…With regard to the second application of "RLN function monitoring", statistically reliable data of prospective multicentre studies are still lacking. Results of single-centre studies [12,13,14] are available, but the overall reliability of the intra-operative received IONM signals for RLN function monitoring during thyroid gland dissection has still not been evaluated. To clarify if IONM is reliable for the monitoring of RLN function during thyroid surgery we conducted this prospective multicentre study.…”

Section: Introductionmentioning

confidence: 99%

Validity of intra-operative neuromonitoring signals in thyroid surgery

Thomusch

Sekulla

Machens

et al. 2004

Langenbecks Arch Surg

173

155

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For intra-operative neuromonitoring, indirect stimulation of the RLN is superior to direct stimulation. An intact acoustic IONM signal is highly predictive of intact postoperative RLN function. When the IONM signal is abnormal or absent, a one-stage extensive thyroid resection should be performed only if the surgeon is absolutely convinced that the first RLN is not harmed or a total thyroidectomy is mandatory.

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Section: Introductionmentioning

confidence: 99%

Validity of intra-operative neuromonitoring signals in thyroid surgery

Thomusch

Sekulla

Machens

et al. 2004

Langenbecks Arch Surg

173

155

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“…Visual identification of the RLN during thyroid surgery has been shown to be associated with better outcomes than are methods of neural avoidance during thyroidectomy [9, 14, 17]. RLN intraoperative monitoring adds a functional dimension to surgery that aids, but does not replace, visual identification [18].…”

mentioning

confidence: 99%

Recurrent Laryngeal Nerve Identification and Assessment during Thyroid Surgery: Laryngeal Palpation

2004

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Electrical identification and monitoring of the recurrent laryngeal nerve (RLN) has been proposed as an adjunct to standard visual identification of the nerve during thyroid and parathyroid surgery. This study was undertaken to assess laryngeal palpation as an intraoperative technique for identifying and assessing the RLN during surgery and to investigate the relation between laryngeal palpation and associated laryngeal electromyographic (EMG) activity. The postcricoid region of the larynx during surgery was palpated through the posterior hypopharyngeal wall to sense posterior cricoarytenoid muscle contraction in response to ipsilateral RLN stimulation (i.e., the "laryngeal twitch response.") Laryngeal palpation was performed in a series of 449 consecutive thyroid and parathyroid surgeries with 586 RLNs at risk. All patients underwent preoperative and postoperative laryngoscopy to assess vocal cord mobility. In a subset of patients, laryngeal palpation and simultaneous laryngeal EMG recordings were compared during intraoperative RLN stimulation. In this series, there was no permanent RLN paralysis. There was one case of temporary RLN paralysis secondary to neural stretch that resolved 6 weeks postoperatively (temporary paralysis rate: 0.2% of patients, 0.2% of nerves at risk). Intraoperative laryngeal palpation of the laryngeal twitch response reliably correlated with normal postoperative vocal cord function. Loss of the laryngeal twitch response occurred in the single case of temporary paralysis in the setting of an anatomically intact nerve. Laryngeal palpation correlated well with simultaneous laryngeal EMG activity. There were no palpation-induced laryngeal injuries or laryngeal edema. There were also no RLN injuries due to repetitive neural stimulation. Intraoperative laryngeal palpation during RLN stimulation is a safe, reliable method for neural monitoring that can assist in RLN identification and assessment during thyroid and parathyroid surgery. Most importantly, it provides important prognostic information regarding ipsilateral vocal cord function at the completion of the initial side of the thyroid or parathyroid surgery. Intraoperative laryngeal palpation allows the surgeon to stage contralateral surgery if RLN damage is diagnosed, thereby avoiding the potential for bilateral vocal cord paralysis. We believe that laryngeal palpation is useful as an adjunct to formal EMG monitoring during thyroid and parathyroid surgery.

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“…Através deste método torna-se possível acoplar sistemas de fotografia ou filmagem por meio de microcâmaras e documentar o exame, gravando-o em mídia eletrônica 32,39,45,58,64,119,151 . intra-operatória 33,49,55, , eletrodos intramusculares 50,[66][67][68]72,122,134 ou retrocricóideos 50,71,79,86 34,49,52,55,[59][60][61][62][63]69,111,[125][126][127][128] .…”

Section: Variávelunclassified

Análise da integridade e funcionalidade do nervo laríngeno recorrente após tireoidectomias - estudo comparativo com e sem a utilização da eletroneuromiografia intra-operatório

Volpi¹

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Identification and functional recording of the recurrent nerve by electrical stimulation during neck surgery

Cited by 13 publications

References 0 publications

Validity of intra-operative neuromonitoring signals in thyroid surgery

Validity of intra-operative neuromonitoring signals in thyroid surgery

Recurrent Laryngeal Nerve Identification and Assessment during Thyroid Surgery: Laryngeal Palpation

Análise da integridade e funcionalidade do nervo laríngeno recorrente após tireoidectomias - estudo comparativo com e sem a utilização da eletroneuromiografia intra-operatório

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