Transtracheales Monitoring des Nervus laryngeus recurrens Der Prototyp eines neuen Tubus

Abstract

A new sensing device for the continuous intraoperative monitoring of the recurrent laryngeal nerve is presented. It is based on a double ballooned endotracheal tube including stimulating and tracing electrodes. The system is characterised by three advantages: 1) it is atraumatic, 2) it is operating completely outside the operating field (extraterritorially), 3) nerve function is being monitored continuously from the time of intubation to the time of extubation. The presented system has been evaluated in piglets. First results in humans will be available shortly.

A new anchor electrode design for continuous neuromonitoring of the recurrent laryngeal nerve by vagal nerve stimulations

“…To overcome this limitation, a real-time monitoring system to close the stimulation gap is desirable. The double-balloon electromyography (EMG) tube by Lamadé et al [16] as the first published continuous neuromonitoring system failed because of technical and economic reasons [29].…”

Intraoperative elektromyographische Recurrensidentifizierung als Routinemaßnahme

“…Abb. Patientendaten, Beschreibung der OP-Indikation, des OP-Verfahrens oder postoperative Recurrensbefunde fehlen in dieser Arbeit allerdings ebenso wie eine Einschätzung der Notwendigkeit des Monitorings zur Nerverkennung.LamadØ et al[7,8] stellen ein kontinuierliches Monitoringsystem vor, bei dem eine in einem Doppelballontubus integrierte Elektrode die Ableitung und Stimulierung des Nerven transtracheal ermöglicht.Während unserer Untersuchungsperiode betrug bei 174 stimulierten Nerven die permanente Pareserate nur 0,6 %. Tubus und Oberflächenklebeelektrode; die Elektrode wird zirkulär 2 cm oberhalb des Cuffs angeklebt und beim Intubieren zwischen die Stimmlippen plaziert; ihre Funktionsfähigkeit wird nach endgültiger Lagerung durch transcutane Stimulation des Recurrensnerven überprüft Resektion solitärer Knoten im Isthmusbereich kann darauf verzichtet werden.…”

Intraoperative electromyogram monitoring of the recurrent laryngeal nerve: experience with an intralaryngeal surface electrode

“…Techniques helping to localize the nerve intraoperatively have been tested and discussed from time to time [5,6,7,8,9,10]. Until now, no method proved to be recommendable as a standard, since they have been too complicated (intralaryngeal pressure sensors [11,12]) or very traumatic to the tissue (an intralaryngeal wire hooked to vocal-cord needle electrodes [10,13]).…”