• Journal of Clinical Otolaryngology Head and Neck Surgery
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• v.29 no.2
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• pp.177-181
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• 2018

• International journal of thyroidology
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• v.11 no.2
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• pp.109-116
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• 2018

It is very important to identify recurrent laryngeal nerve (RLN) and prevent RLN injury during thyroid surgery. The intraoperative neuromonitoring (IONM) for the prevention of RLN injury is a useful method because it can identify the location and status of RLN and predict postoperative vocal cord function easily. The IONM consists of a stimulating side that applies electrical stimulation to the nerve and a recording side that measures the surface electromyography (EMG) of the vocal cord muscle through electrode endotracheal tube. The nerve stimulator and surgical dissector are separate instruments. So, during IONM for the prevention of the RLN injury in conventional, endoscopic, or robotic thyroid surgery, repeated exchanging between surgical instruments and the nerve stimulator is inconvenient and time consuming. On the recording side, the accuracy of the electrode endotracheal tube which measures the EMG of the vocalis muscle can be affected by contact with between electrode and vocal fold and position change of patient. We would like to introduce recent several researches to overcome the current limitations of IONM.

• Journal of Clinical Otolaryngology Head and Neck Surgery
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• v.29 no.2
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• pp.167-172
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• 2018

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.1
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• pp.13-15
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• 2015

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.

• Proceedings of the KSLP Conference
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• 2015.03a
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• pp.46-48
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• 2015

• Korean Journal of Clinical Laboratory Science
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• v.52 no.4
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• pp.317-326
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• 2020

Deep blocking of consciousness alone does not prevent a reaction to severe stimuli, and copious amounts of pain medication do not guarantee unconsciousness. Therefore, anesthesia must satisfy both: the loss of consciousness as well as muscle relaxation. Muscle relaxants improve the intra-bronchial intubation, surgical field of vision, and operating conditions, while simultaneously reducing the dose of inhalation or intravenous anesthesia. Muscle relaxants are also very important for breathing management during controlled mechanical ventilation during surgery. Excessive dosage of such muscle relaxants may therefore affect neurological examinations during surgery, but an insufficient dosage will result in movement of the patient during the procedure. Hence, muscle relaxation anesthesia depth and neurophysiological monitoring during surgery are closely related. Using excessive muscle relaxants is disadvantageous, since neurophysiological examinations during surgery could be hindered, and eliminating the effects of complete muscle relaxation after surgery is challenging. In the operation of neurophysiological monitoring during the operation, the anesthesiologist administers muscle relaxant based on what standard, it is hoped that the examination will be performed more smoothly by examining the trends in the world as well as domestic and global trends in maintaining muscle relaxant.

• Journal of Clinical Otolaryngology Head and Neck Surgery
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• v.29 no.2
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• pp.157-161
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• 2018

• Korean Journal of Clinical Laboratory Science
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• v.48 no.3
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• pp.262-268
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• 2016

Hemifacial spasm is a disease caused by involuntary facial muscles with repeated unilateral convulsive spasms. It involves contraction of multiple muscles at the same time (synkinesia). The pathogenesis appears to be the pressure on the vessel by the facial nerve. This study included hemifacial spasm patients, who received microvascular decompression surgery. Brainstem auditory evoked potential and the examination time were carefully noted when using brain surgical retractor. The facial nerve electromyography tests for the identification of artifacts and EMG waveform when the facial nerve damage, about the importance of the maintenance of anesthesia in the lateral spread response and in a somatosensory evoked potential propose a new method. Based on the above test, it will be more effective.

• Korean Journal of Head & Neck Oncology
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• v.24 no.1
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• pp.3-8
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• 2008

• Korean Journal of Clinical Laboratory Science
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• v.53 no.1
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• pp.122-130
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• 2021

The types of artifacts that are observed in intraoperative neurophysiological monitoring (INM) is truly diverse. The removal of artifacts that interfere with the examination is essential. In addition, improving the quality of the examination by removing artifacts is a reflection of the competency of the examiner and is also the best way to ensure patient safety. However, if knowledge of the equipment or anesthesia in the operating room is insufficient due to lack of experience, artifacts cannot be removed even with a method appropriate to the situation. If artifacts are not separated and removed, the reading of the examination results in confusion in the operation process. This can be a fatal problem in neurosurgery that requires rapid and sophisticated procedures. In this paper, the causes of artifacts that occur during surgery are classified into electrical factors, non-electrical factors, and other factors, and a method and examination method for removing artifacts according to the specific situation is mentioned. Although the operating room environment is a very critical place to simultaneously consider various scenarios, we hope that a stable and optimal INM will play a role by knowing the types and causes of various artifacts and how to tackle them.