Safety analysis of vagal nerve stimulation for continuous nerve monitoring during thyroid surgery

Friedrich, C.; Ulmer, Christoph; Rieber, Fabian; Kern, Eva; Kohler, Andrea; Schymik, K.; Thon, Klaus‐Peter; Lamadé, Wolfram

doi:10.1002/lary.23411

Cited by 51 publications

(34 citation statements)

References 44 publications

(81 reference statements)

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“…[71] Vagus nerve stimulation during the neck surgery may be responsible. [7072] In addition, the following factors may play an important role: female gender, age, nonsmoker, and history of nausea and vomiting. [73] Treatment with antiemetics can improve this symptom within 1–2 days.…”

Section: Resultsmentioning

confidence: 99%

Complications Following Radiofrequency Ablation of Benign Thyroid Nodules

Wang

et al. 2017

Chinese Medical Journal

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Objective:This systematic review examined whether radiofrequency ablation (RFA) is a safe treatment modality for benign thyroid nodules (BTNs).Data Sources:PubMed, Embase, and the Cochrane Library database were searched for articles that (a) targeted human beings and (b) had a study population with BTNs that were confirmed by fine-needle aspiration cytology and/or core needle biopsy.Study Selection:Thirty-two studies relating to 3409 patients were included in this systematic review.Results:Based on literatures, no deaths were associated with the procedure, serious complications were rare, and RFA appears to be a safe and well-tolerated treatment modality. However, a broad spectrum of complications offers insights into some undesirable complications, such as track needle seeding and Horner syndrome.Conclusions:RFA appears to be a safe and well-tolerated treatment modality for BTNs. More research is needed to characterize the complications of RFA for thyroid nodules.

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Section: Resultsmentioning

confidence: 99%

Complications Following Radiofrequency Ablation of Benign Thyroid Nodules

Wang

et al. 2017

Chinese Medical Journal

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“…In our first case of RLN injury, device malfunction was identified as the main reason of injury. Continuous IONM would gain a lot of benefit in this situation and prevent nerve injury [19]. …”

Section: Discussionmentioning

confidence: 99%

Protective effect of intraoperative nerve monitoring against recurrent laryngeal nerve injury during re-exploration of the thyroid

Chuang

Huang

2013

World J Surg Onc

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BackgroundPrevious thyroid or parathyroid surgery induces scarring or distorts anatomy, and increases the risk of recurrent laryngeal nerve (RLN) injury for a reoperation. The benefit of intraoperative nerve monitoring (IONM) for re-exploration (a second nerve exploration) and reoperation has not been established.MethodsTwo hundred and ten patients were given a thyroid or parathyroid reoperation at our hospital between 2001 and 2010. Using IONM, we re-explored 56 patients who had been operated on before June 2007. The injury rate in these patients was compared with that of the 15 patients re-explored without IONM between 2001 and 2006.ResultsOf the 70 nerves that were re-explored using IONM, only one was incidentally injured, significantly fewer than the three injured in the 15 nerves re-explored without using IONM (1.43% vs. 20%, P = 0.0164).ConclusionsIONM helped prevent RLN damage when re-exploring nerves during thyroid and parathyroid surgery. We recommend the routine use of IONM in thyroid and parathyroid reoperations.

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“…Beside two anecdotal reports of local and cardiac complications during CIONM in a very few patients (20,21), there are several clinical data showing no evidence of adversity related to the circular dissection of the a vagal nerve segment or related intrinsically to CIONM (11,15,17,19,(22)(23)(24)(25)(26)(27).…”

Section: Safety Of Continuous Neural Monitoringmentioning

confidence: 99%

“…Furthermore, the 1 mA stimulation current used for CIONM is not believed to engender concomitant or subsequent adverse vagal effect leading to central (headache, numbness), cardiac (arrhythmias, bradycardia), pulmonary (bronchospasm), or gastrointestinal (nausea, vomiting) symptoms (9,11,15,17,26,27,30,31). Studies (22,25) that applied stimulation current up to 5.0 mA for CIONM, observed an increased variability in heart rate, implying autonomic nervous system imbalance. The elicited parasympathetic activation was not associated with a compensatory increase in sympathetic activity and remained subclinical.…”

Section: Safety Of Continuous Neural Monitoringmentioning

confidence: 99%

Continuous intraoperative neural monitoring of the recurrent nerves in thyroid surgery: a quantum leap in technology

et al. 2016

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Safety analysis of vagal nerve stimulation for continuous nerve monitoring during thyroid surgery

Abstract: VNS for CIONM resulted in increased vagal activity assessable via HRVA. The increased parasympathetic tone affected neither hemodynamics nor levels of the proinflammatory cytokine TNF-α. VNS for CIONM appears safe with the applied settings.

Cited by 51 publications

References 44 publications

Complications Following Radiofrequency Ablation of Benign Thyroid Nodules

Complications Following Radiofrequency Ablation of Benign Thyroid Nodules

Protective effect of intraoperative nerve monitoring against recurrent laryngeal nerve injury during re-exploration of the thyroid

Continuous intraoperative neural monitoring of the recurrent nerves in thyroid surgery: a quantum leap in technology

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