Intraoperative Laryngeal Nerve Monitoring During Thyroidectomy

被引:22
|
作者
Donnellan, Kimberly A. [1 ]
Pitman, Karen T. [1 ]
Cannon, C. Ron [4 ]
Replogle, William H. [2 ]
Simmons, Jon D. [3 ]
机构
[1] Univ Mississippi, Med Ctr, Dept Otolaryngol Head & Neck Surg, Jackson, MS 39216 USA
[2] Univ Mississippi, Med Ctr, Dept Family Practice, Jackson, MS 39216 USA
[3] Univ Mississippi, Med Ctr, Dept Gen Surg, Jackson, MS 39216 USA
[4] Rankin Med Ctr, Dept Otolaryngol Head & Neck Surg, Jackson, MS USA
关键词
PARATHYROIDECTOMY; PARALYSIS; RISK;
D O I
10.1001/archoto.2009.167
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Objective: To determine whether nerve integrity monitor testing during thyroidectomy predicts recurrent laryngeal nerve (RLN) function after surgery. Design: Prospective cohort outcomes study Patients: The study included 210 consecutive patients with thyroid abnormalities who underwent thyroidectomy. Methods: All patients were intraoperatively monitored with a nerve integrity monitoring system (Xomed NIM II; Medtronic Inc, Fridley, Minnesota), and their vocal cord function was assessed with fiberoptic laryngoscopy before and after surgery. Normal and impaired vocal cord function were compared using an independent t test with respect to postoperative vocal cord mobility, length of the RLN dissection, and the minimum stimulus needed to generate a response at the completion of surgery. Results: There was a statistically significant difference between the stimulus in milliamperes required to stimulate normal vs abnormal functioning nerves at the completion of the procedure at the cricoarytenoid joint (P=.02) and at the distal end of the RLN dissection (P<.01). A greater length of dissected nerve was associated with normal vocal cord function; however, it was not Statistically significant (P=.07). Conclusion: These data suggest that an RLN that responds at lower-intensity stimulation (<= 0.5 mA) at the end of thyroid surgery is associated with normal vocal cord mobility.
引用
收藏
页码:1196 / 1198
页数:3
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