Kontinuierliches intraoperatives Neuromonitoring (cIONM) in der Kopf-Hals-Chirurgie – eine Übersicht

Stankovic, Petar; Wittlinger, Jan; Georgiew, R; Dominas, Nina; Hoch, Stephan; Wilhelm, Thomas

doi:10.1007/s00106-020-00823-2

Cited by 3 publications

(3 citation statements)

References 39 publications

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“…Although an elevated nerve response (0.5 mA) could predict postoperative facial nerve paresis at the end of procedure, an absence of an electrically evoked response does not exclude the facial nerve injury (15,17). The incidence of temporary postoperative facial weakness in our cohort is much lower than that in the recent meta-analysis (1.7% vs. 23.4%, adjusted OR 0.06, 95% CI 0.01 to 0.23, P = 0.0001) (16). Possible explanations are that most data in that meta-analysis were based on studies with 2-channel systems during parotidectomy, while we used passive 4 channel-monitoring (electrode placement in the frontal, orbicularis oculi and oris, and mentalis muscles).…”

Section: Discussioncontrasting

confidence: 78%

“…Dissection, transaction, laceration, clamp compression, retraction, electrocautery, ligature entrapment, suction trauma, or even compressive ischemia can cause iatrogenic facial nerve injury ( 17 ). cIONM during parotid surgery allows early nerve identification, forewarns surgeons of unexpected facial nerve stimulation, maps the nerve course, reduces mechanical nerve damage, and helps to evaluate and prognosticate the nerve function at the end of the procedure ( 15 , 16 ). This real-time monitoring of the facial nerve undoubtedly decreases operation time and increases patient satisfaction ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

“…In the MFL group, the patients were informed about the chance of intraoperative converting the incision into the conventional MBI, depending on surgical difficulty. All subjects received routine use of general anaesthetics and continuous intraoperative neuromonitoring (cIONM) of the facial nerve, as described by other authors ( 15 , 16 , 17 ). Subjects were excluded from the study if they did not satisfy the inclusion criteria, had poor general health (American Society of Anesthesiology [ASA] status IIIIV), or if infection became disseminating to other tissues/ organs or arose from a tumor (“tumor necrosis”).…”

Section: Methodsmentioning

confidence: 99%

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Length of hospital stay and complications of mini-facelift versus modified Blair incision for parotid abscess drainage

Arnnop¹,

Sirintawat²,

Subbalekha³

et al. 2022

eor

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PurposeTo compare the length of hospital stay (LHS) and complications between minifacelift (MFL) and modified Blair incisions (MBI) for adult patients undergoing parotid abscess drainage (PAD). Materials and MethodsA retrospective cohort study design was utilized comprising 2 groups of healthy adult patients (American Society of Anesthesiology [ASA] status I-II) who underwent PAD during a 7-year interval. The primary predictor variable was incision type (MFL vs. MBI). The primary outcomes were LHS and adverse complications resulting from the incision type. Other study variables were grouped into demographic, clinical, microbiological, and therapeutic categories. Difference in the cohort characteristics were analyzed using appropriate descriptive and uni-and bivariate statistics. Multivariate logistic regression was used to measure the effect of the incision type had on the LHS and adverse complication rates. ResultsThe sample included 120 subjects (50% females) with a mean age of 41.7±18.3 years. Patients in the MFL group were hospitalized for 8.2±7.7 days, and the other group stayed in the hospital for 10.2±8 days (adjusted odd ratio [OR] 1.19, 95% confidence interval [95% CI] 0.52 to 2.7; p=0.8). In comparison with MBI, MFL did not significantly increase complication risks in term of facial paralysis (adjusted OR 0.93, 95% CI 0.06 to 15.29; p=1.0) and necessity of re-operation (adjusted OR 0.61, 95% CI 0.1 to 3.8; p=0.7). ConclusionGiven no different LHS and complication risks, MFL can replace MBI for ASA I-II adult patients undergoing PAD.

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Section: Discussioncontrasting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Length of hospital stay and complications of mini-facelift versus modified Blair incision for parotid abscess drainage

Arnnop¹,

Sirintawat²,

Subbalekha³

et al. 2022

eor

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Monitoring in Facial, Neck, and Ear Surgeries

Oliveira¹,

Lladó-Carbó²,

Ferreira

et al. 2022

Intraoperative Monitoring

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Continuous Intraoperative Nerve Monitoring of a Non-Recurrent Laryngeal Nerve: Real-Life Data of a High-Volume Thyroid Surgery Center

Lederer,

Staubitz-Vernazza,

Margies

et al. 2024

Cancers

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Thyroid surgery is associated with a risk of injury to the recurrent laryngeal nerve, especially in the presence of anatomical variants such as a non-recurrent laryngeal nerve (NRLN). Injury to the nerve leads to transient or permanent vocal cord palsy (VCP). A novel method to prevent VCP is continuous intraoperative nerve monitoring (cIONM), but less is known about the applicability of this method in patients with NRLN. The aim of this study was to evaluate our own data regarding feasibility and detailed characteristics of cIONM in NRLN patients. We performed a monocentric retrospective cohort analysis including clinical data and intraoperative nerve monitoring data (measured by Inomed Medizintechnik GmbH, Emmendingen, ‘C2’ and ‘C2 Xplore’ device) of all thyroid surgery patients, showing NRLN between 2014 and 2022. Of 1406 patients who underwent thyroid surgery with cIONM between 2014 and 2022, 12 patients (0.9%) showed NRLN intraoperatively. Notably, cIONM was feasible in eight patients (67%). In all cases the onset latency of the right vagus nerve was shorter (<3.0 ms) than usually expected, suggesting that a short latency might be suitable to distinguish NRLN. None of the patients had a post-operative VCP. Overall, cIONM appears to be feasible and safe in NRLN patients and provides helpful information to prevent VCP.

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Kontinuierliches intraoperatives Neuromonitoring (cIONM) in der Kopf-Hals-Chirurgie – eine Übersicht

Cited by 3 publications

References 39 publications

Length of hospital stay and complications of mini-facelift versus modified Blair incision for parotid abscess drainage

Length of hospital stay and complications of mini-facelift versus modified Blair incision for parotid abscess drainage

Monitoring in Facial, Neck, and Ear Surgeries

Continuous Intraoperative Nerve Monitoring of a Non-Recurrent Laryngeal Nerve: Real-Life Data of a High-Volume Thyroid Surgery Center

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