Superior laryngeal nerve monitoring using laryngeal surface electrodes and intraoperative neurophysiological monitoring during thyroidectomy.
Identifieur interne : 000298 ( Main/Exploration ); précédent : 000297; suivant : 000299Superior laryngeal nerve monitoring using laryngeal surface electrodes and intraoperative neurophysiological monitoring during thyroidectomy.
Auteurs : Benjamin L. Hodnett [États-Unis] ; Nicole C. Schmitt ; Daniel R. Clayburgh ; Alex Burkowsky ; Jeffrey Balzer ; Parthasarathy D. Thirumala ; Umamaheswar DuvvuriSource :
- Clinical anatomy (New York, N.Y.) [ 1098-2353 ] ; 2015.
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English descriptors
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Abstract
The objective of this study is to establish normative waveform data for the external branch of the superior laryngeal nerve (SLN) utilizing laryngeal surface electrodes and intraoperative neurophysiological monitoring (IONM) in conjunction with a clinical neurophysiologist. A retrospective chart review of 91 consecutive at-risk SLN were identified in 51 patients in whom IONM using laryngeal surface electrodes was performed by a clinical neurophysiologist using Dragonfly (Neurovision Medical Products, Ventura, CA) recording electrodes and a Protektor (Natus Medical Inc., San Carlos, CA)16 channel- intraoperative nerve monitoring system. Inclusion criteria were met for 30 SLN. Data collected included preoperative diagnosis, surgical procedure, rates of nerve identification and stimulation, and waveform characteristics. Waveform analysis for 30 SLN yielded a peak latency of 4.0 ± 0.2 ms, onset latency 2.3 ± 0.1 ms, peak-to-peak amplitude of 220.4 ± 31.1 µV, onset-to-peak amplitude of 186.0 ± 25.0 µV, and stimulation current threshold of 0.55 ± 0.03 mA (data = mean ± SEM). Two patients had abnormal SLN function documented clinically on postoperative laryngoscopic examination. Laryngeal surface electrodes were successfully utilized to identify and monitor SLN function intraoperatively. IONM using laryngeal surface electrodes enables analysis of waveform morphology and latency in addition to threshold and amplitude data obtained with the traditional NIM system, potentially improving the performance of nerve monitoring during thyroid surgery.
DOI: 10.1002/ca.22487
PubMed: 25425500
Affiliations:
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Hodnett</name><affiliation wicri:level="2"><nlm:affiliation>Department of Otolaryngology, University of Pittsburgh Medical Center, Eye and Ear Institute, Pittsburgh, Pennsylvania.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Otolaryngology, University of Pittsburgh Medical Center, Eye and Ear Institute, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Schmitt, Nicole C" sort="Schmitt, Nicole C" uniqKey="Schmitt N" first="Nicole C" last="Schmitt">Nicole C. Schmitt</name></author><author><name sortKey="Clayburgh, Daniel R" sort="Clayburgh, Daniel R" uniqKey="Clayburgh D" first="Daniel R" last="Clayburgh">Daniel R. 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Thirumala</name></author><author><name sortKey="Duvvuri, Umamaheswar" sort="Duvvuri, Umamaheswar" uniqKey="Duvvuri U" first="Umamaheswar" last="Duvvuri">Umamaheswar Duvvuri</name></author></analytic><series><title level="j">Clinical anatomy (New York, N.Y.)</title><idno type="eISSN">1098-2353</idno><imprint><date when="2015" type="published">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Child</term><term>Electrodes</term><term>Female</term><term>Humans</term><term>Intraoperative Neurophysiological Monitoring</term><term>Laryngeal Nerves (physiology)</term><term>Male</term><term>Middle Aged</term><term>Reference Values</term><term>Retrospective Studies</term><term>Thyroidectomy</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Enfant</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Mâle</term><term>Nerfs laryngés (physiologie)</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Surveillance neurophysiologique peropératoire</term><term>Thyroïdectomie</term><term>Valeurs de référence</term><term>Électrodes</term><term>Études rétrospectives</term></keywords><keywords scheme="MESH" qualifier="physiologie" xml:lang="fr"><term>Nerfs laryngés</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Laryngeal Nerves</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Child</term><term>Electrodes</term><term>Female</term><term>Humans</term><term>Intraoperative Neurophysiological Monitoring</term><term>Male</term><term>Middle Aged</term><term>Reference Values</term><term>Retrospective Studies</term><term>Thyroidectomy</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Enfant</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Mâle</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Surveillance neurophysiologique peropératoire</term><term>Thyroïdectomie</term><term>Valeurs de référence</term><term>Électrodes</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The objective of this study is to establish normative waveform data for the external branch of the superior laryngeal nerve (SLN) utilizing laryngeal surface electrodes and intraoperative neurophysiological monitoring (IONM) in conjunction with a clinical neurophysiologist. A retrospective chart review of 91 consecutive at-risk SLN were identified in 51 patients in whom IONM using laryngeal surface electrodes was performed by a clinical neurophysiologist using Dragonfly (Neurovision Medical Products, Ventura, CA) recording electrodes and a Protektor (Natus Medical Inc., San Carlos, CA)16 channel- intraoperative nerve monitoring system. Inclusion criteria were met for 30 SLN. Data collected included preoperative diagnosis, surgical procedure, rates of nerve identification and stimulation, and waveform characteristics. Waveform analysis for 30 SLN yielded a peak latency of 4.0 ± 0.2 ms, onset latency 2.3 ± 0.1 ms, peak-to-peak amplitude of 220.4 ± 31.1 µV, onset-to-peak amplitude of 186.0 ± 25.0 µV, and stimulation current threshold of 0.55 ± 0.03 mA (data = mean ± SEM). Two patients had abnormal SLN function documented clinically on postoperative laryngoscopic examination. Laryngeal surface electrodes were successfully utilized to identify and monitor SLN function intraoperatively. IONM using laryngeal surface electrodes enables analysis of waveform morphology and latency in addition to threshold and amplitude data obtained with the traditional NIM system, potentially improving the performance of nerve monitoring during thyroid surgery.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Pennsylvanie</li></region></list><tree><noCountry><name sortKey="Balzer, Jeffrey" sort="Balzer, Jeffrey" uniqKey="Balzer J" first="Jeffrey" last="Balzer">Jeffrey Balzer</name><name sortKey="Burkowsky, Alex" sort="Burkowsky, Alex" uniqKey="Burkowsky A" first="Alex" last="Burkowsky">Alex Burkowsky</name><name sortKey="Clayburgh, Daniel R" sort="Clayburgh, Daniel R" uniqKey="Clayburgh D" first="Daniel R" last="Clayburgh">Daniel R. Clayburgh</name><name sortKey="Duvvuri, Umamaheswar" sort="Duvvuri, Umamaheswar" uniqKey="Duvvuri U" first="Umamaheswar" last="Duvvuri">Umamaheswar Duvvuri</name><name sortKey="Schmitt, Nicole C" sort="Schmitt, Nicole C" uniqKey="Schmitt N" first="Nicole C" last="Schmitt">Nicole C. Schmitt</name><name sortKey="Thirumala, Parthasarathy D" sort="Thirumala, Parthasarathy D" uniqKey="Thirumala P" first="Parthasarathy D" last="Thirumala">Parthasarathy D. Thirumala</name></noCountry><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Hodnett, Benjamin L" sort="Hodnett, Benjamin L" uniqKey="Hodnett B" first="Benjamin L" last="Hodnett">Benjamin L. Hodnett</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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