Intraoperative elektromyographische Recurrensidentifizierung als Routinemaßnahme

Abstract

In recent years, two methods of intraoperative monitoring of the laryngeal nerve have mostly been used: evoked electromyographic responses via endscopically applied needle electrodes inserted into the adducting laryngeal muscles, and non-invasive electrodes like special tubes with integrated electrodes or separately insertable electrodes like the postcricoid electrode or disposable electrodes attached to the tube, as used in this study. The incidence of recurrent nerve paresis or paralysis during the IRM period was 1/174 nerves (0.6%). The advantage of the IRM is the quick and certain identification of the nerve; intraoperative monitoring cannot replace a proper surgical technique. We conclude that the IRM, using a laryngeal surface electrode attached to the tube, is a safe and reliable method.

Electromyographic response persists after peripheral transection: endorsement of current concepts in recurrent laryngeal nerve monitoring in a porcine model

“…Nevertheless, the intraoperative recurrent laryngeal nerve monitoring has many plaudits [12] and might be particularly useful [8,9] to identify the region were the nerve is located, even in difficult surgical fields before an involuntary and ultimate transection occurs [19]. The less experienced surgeon might use it as a guide in the same sense [13].…”

“…One of the most common methods is the evoked laryngeal electromyography, which could be achieved via laryngeal needle electromyography or surface electrodes on an endotracheal tube [6][7][8][9][10][11].…”

Neuromonitoring of the Recurrent Nerve: Validation and Merits

“…Neuromonitoring has been shown to enhance the probability of identifying the recurrent nerve (6) and to prevent a misinterpretation of anatomical structures that may appear as nerves on first glance (14). Accordingly, the majority of surgeons rate neuromonitoring as helpful; this score is more positive in less experienced surgeons and neuromonitoring is considered particularly helpful in complicated surgery (11).…”

Comparison of two electromyographical endotracheal tube systems for intraoperative recurrent laryngeal nerve monitoring: reliability and side effects

“…One of the most common methods is the evoked laryngeal electromyography (EMG), which could be achieved via laryngeal needle electromyography, laryngeal electrodes or surface electrodes on an endotracheal tube (ETT) [6,[9][10][11][12]15]. The clinical performance of the electrode systems could differ [13] as each electrode set might record electromyographic response from different muscles.…”