Life-Threatening Complication of Recurrent Laryngeal Nerve Monitoring With EMG Reinforced Silicone ETT

Oysu, Çağatay; Demir, Kadri

doi:10.1097/scs.0b013e318232a734

Cited by 11 publications

(7 citation statements)

References 1 publication

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“…In an animal trachea, the same authors showed that overinflated cuff may herniate and block ETT tip easily (12). A 25-mm upward movement of the ETT was found as a contributing factor to cuff herniation.…”

Section: Ett Complicationsmentioning

confidence: 86%

Improving Safety of Neural Monitoring in Thyroid Surgery: Educational Considerations in Learning New Procedure

et al. 2018

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Literature on intraoperative neuro monitoring (IONM) during endocrine surgery have increased over recent years. A comprehensive understanding of the role of IONM for prevention of nerve injuries is critical to maximize safety during surgery of the anterior compartment of the neck. Neuromonitoring techniques are currently considered safe technique and technology; however, albeit sporadically, have been reported some complications and related side effects using such methods. The complications described can be related to the electrodes positioned at the larynx, at the obstruction of the endotracheal tube, the drugs used for anesthesia and the effects of electrical stimulation on nerve structures and systemic levels. This review will explore the safety issues of IONM to improve the outcomes among patients undergoing monitored thyroidectomy.

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Section: Ett Complicationsmentioning

confidence: 86%

Improving Safety of Neural Monitoring in Thyroid Surgery: Educational Considerations in Learning New Procedure

et al. 2018

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“…A learning curve has been described for their accurate placement, where the EMG endotracheal tube required readjustment for successful recurrent larygneal nerve monitoring after intubation in 10% of the patients (Dionigi et al, 2008). EMG endotracheal tubes may be more prone than other endotracheal tubes to cuff herniation after overfilling and tube traction, resulting in the blockage of ventilation (Oysu and Demir, 2011).…”

Section: Discussionmentioning

confidence: 99%

Alternative Sites for Intraoperative Monitoring of Cranial Nerves X and XII During Intracranial Surgeries

Holdefer

Kinney

Robinson

et al. 2013

Journal of Clinical Neurophysiology

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During intracranial surgeries, cranial nerve (CN) X is most commonly monitored with electromyographic endotracheal tubes. Electrodes on these endotracheal tubes may be displaced from the vocal folds during positioning, and there is a learning curve for their correct placement. Cranial nerve XII is most commonly monitored with electrodes in the dorsum of the tongue, which are also prone to displacement because of their proximity to the endotracheal tube. A retrospective review was conducted of a consecutive series of 83 skull base surgeries using alternative sites for monitoring CN X and XII. On-going (spontaneous) and evoked electromyography (EMG) were obtained from the cricothyroid muscle for CN X and submental genioglossus for CN XII. Stimulation of CN X or XII evoked specific compound motor action potentials from these muscles, and well-defined on-going EMG was observed during tumor resection in the vicinity of CN X and XII. Volume-conducted responses from the adjacent platysma muscle during CN VII stimulation were identified by concomitant responses from the orbicularis oris and oculi. In conclusion, during skull base surgeries, CN X may be monitored with electrodes in the cricothyroid muscle and CN XII with electrodes in the submental genioglossus. These alternative sites are less prone to displacement of electrodes compared with the more commonly used EMG endotracheal tube and electrodes in the dorsum of the tongue. The cricothyroid muscle should not be used when the recurrent laryngeal nerve is at risk.

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“…Unlike during thyroid surgery, the cuff electrode cannot be relocated to the true vocal fold during 1-lung ventilation, as it would jeopardize adequate ventilation and interfere with the operative field. Some cases in which the E-tube balloon completely blocked the airway during operation have been reported [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Recurrent Laryngeal Nerve Monitoring in a Patient with Contralateral Vocal Fold Palsy

Choi

Park

et al. 2017

Korean J Thorac Cardiovasc Surg

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Recurrent laryngeal nerve injury can develop following cervical or thoracic surgery; however, few reports have described intraoperative recurrent laryngeal nerve monitoring. Consensus regarding the use of this technique during thoracic surgery is lacking. We used intraoperative recurrent laryngeal nerve monitoring in a patient with contralateral vocal cord paralysis who was scheduled for completion pneumonectomy. This case serves as an example of intraoperative recurrent laryngeal nerve monitoring during thoracic surgery and supports this indication for its use.

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Life-Threatening Complication of Recurrent Laryngeal Nerve Monitoring With EMG Reinforced Silicone ETT

Cited by 11 publications

References 1 publication

Improving Safety of Neural Monitoring in Thyroid Surgery: Educational Considerations in Learning New Procedure

Improving Safety of Neural Monitoring in Thyroid Surgery: Educational Considerations in Learning New Procedure

Alternative Sites for Intraoperative Monitoring of Cranial Nerves X and XII During Intracranial Surgeries

Intraoperative Recurrent Laryngeal Nerve Monitoring in a Patient with Contralateral Vocal Fold Palsy

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