Intraoperative Neuromonitoring of Recurrent Laryngeal Nerve and Superior Laryngeal Nerve

되돌이후두신경과 상후두신경의 수술중 신경감시

  • Hah, J. Hun (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine) ;
  • Jin, Young Ju (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine)
  • 하정훈 (서울대학교 의과대학 이비인후과학교실) ;
  • 진영주 (서울대학교 의과대학 이비인후과학교실)
  • Published : 2015.06.01

Abstract

Intraoperative neuromonitoring of thyroid surgery has gained universal validity to help in nerve identification, safe nerve dissection, and prediction of postoperative vocal cord function. In this article, standard intraoperative neuromonitoring procedure, interpretation about loss of signal, and the indications covered by health insurance will be described.

Keywords

References

  1. Song CM, Kim H, Kwon TK, Sung MW, Kim KH, Hah JH. Investigation on patients' understanding and concern about the disease and recovery rate in thyroidectomy patients to enhance satisfaction of hospitalization. Korean Journal of Otorhinolaryngology-Head and Neck Surgery 2010;53(9):557-63. https://doi.org/10.3342/kjorl-hns.2010.53.9.557
  2. Hermann M, Alk G, Roka R, Glaser K, Freissmuth M. Laryngeal recurrent nerve injury in surgery for benign thyroid diseases: effect of nerve dissection and impact of individual surgeon in more than 27,000 nerves at risk. Annals of Surgery 2002;235(2):261-8. https://doi.org/10.1097/00000658-200202000-00015
  3. Chiang FY, Wang LF, Huang YF, Lee KW, Kuo WR. Recurrent laryngeal nerve palsy after thyroidectomy with routine identification of the recurrent laryngeal nerve. Surgery 2005;137(3):342-7. https://doi.org/10.1016/j.surg.2004.09.008
  4. Alesina PF, Rolfs T, Hommeltenberg S, Hinrichs J, Meier B, Mohmand W, et al. Intraoperative neuromonitoring does not reduce the incidence of recurrent laryngeal nerve palsy in thyroid reoperations: results of a retrospective comparative analysis. World journal of surgery 2012;36(6):1348-53. https://doi.org/10.1007/s00268-012-1548-6
  5. Cernea CR, Brandao LG, Brandao J. Neuromonitoring in thyroid surgery. Current Opinion in Otolaryngology & Head and Neck Surgery 2012;20(2):125-9. https://doi.org/10.1097/MOO.0b013e32834fa8e6
  6. Dionigi G, Chiang F-Y, Dralle H, Boni L, Rausei S, Rovera F, et al. Safety of neural monitoring in thyroid surgery. International Journal of Surgery 2013;11 Suppl 1:S120-6. https://doi.org/10.1016/S1743-9191(13)60031-X
  7. Randolph GW1, Dralle H; International Intraoperative Monitoring Study Group, Abdullah H, Barczynski M, Bellantone R, et al. Electrophysiologic recurrent laryngeal nerve monitoring during thyroid and parathyroid surgery: international standards guideline statement. The Laryngoscope 2011;121 Suppl 1:S1-16. https://doi.org/10.1002/lary.21119
  8. Snyder SK, Hendricks JC. Intraoperative neurophysiology testing of the recurrent laryngeal nerve: plaudits and pitfalls. Surgery 2005;138(6):1183-91; discussion 91-2. https://doi.org/10.1016/j.surg.2005.08.027
  9. Lu IC, Chu KS, Tsai CJ, Wu CW, Kuo WR, Chen HY, et al. Optimal depth of NIM EMG endotracheal tube for intraoperative neuromonitoring of the recurrent laryngeal nerve during thyroidectomy. World Journal of Surgery 2008;32(9):1935-9. https://doi.org/10.1007/s00268-008-9549-1
  10. Friedrich C, Ulmer C, Rieber F, Kern E, Kohler A, Schymik K, et al. Safety analysis of vagal nerve stimulation for continuous nerve monitoring during thyroid surgery. The Laryngoscope 2012;122(9):1979-87. https://doi.org/10.1002/lary.23411
  11. Rosato L, Avenia N, Bernante P, De Palma M, Gulino G, Nasi PG, et al. Complications of thyroid surgery: analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years. World Journal of Surgery 2004;28(3):271-6. https://doi.org/10.1007/s00268-003-6903-1
  12. Barczynski M, Randolph GW, Cernea CR, Dralle H, Dionigi G, Alesina PF, et al. External branch of the superior laryngeal nerve monitoring during thyroid and parathyroid surgery: International Neural Monitoring Study Group standards guideline statement. The Laryngoscope 2013;123 Suppl 4:S1-14.
  13. Cernea CR, Ferraz AR, Furlani J, Monteiro S, Nishio S, Hojaij FC, et al. Identification of the external branch of the superior laryngeal nerve during thyroidectomy. American Journal of Surgery 1992;164(6):634-9. https://doi.org/10.1016/S0002-9610(05)80723-8
  14. Sanudo J-R, Maranillo E, Leon X, Mirapeix, R-M, Orus C, Quer M. An anatomical study of anastomses between the laryngeal nerves. Laryngoscope 1999;109:983-7. https://doi.org/10.1097/00005537-199906000-00026
  15. Barczynski M, Konturek A, Stopa M, Honowska A, Nowak W. Randomized controlled trial of visualization versus neuromonitoring of the external branch of the superior laryngeal nerve during thyroidectomy. World Journal of Surgery 2012;36(6):1340-7. https://doi.org/10.1007/s00268-012-1547-7
  16. Potenza AS, Phelan EA, Cernea CR, Slough CM, Kamani DV, Darr A, et al. Normative intra-operative electrophysiologic waveform analysis of superior laryngeal nerve external branch and recurrent laryngeal nerve in patients undergoing thyroid surgery. World Journal of Surgery 2013;37(10):2336-42. https://doi.org/10.1007/s00268-013-2148-9