Superior laryngeal nerve monitoring using laryngeal surface electrodes and intraoperative neurophysiological monitoring during thyroidectomy

2014 ◽  
Vol 28 (4) ◽  
pp. 460-466 ◽  
Author(s):  
Benjamin L. Hodnett ◽  
Nicole C. Schmitt ◽  
Daniel R. Clayburgh ◽  
Alex Burkowsky ◽  
Jeffrey Balzer ◽  
...  
Keyword(s):  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Intraoperative Neurophysiological Monitoring ◽  
Neurophysiological Monitoring ◽  
Nerve Monitoring ◽  
Surface Electrodes

scholarly journals Intraoperative Recurrent Laryngeal Nerve Monitoring During Pediatric Cardiac and Thoracic Surgery: A Mini Review

2020 ◽  
Vol 8 ◽  
Author(s):  
Claire M. Lawlor ◽  
Benjamin Zendejas ◽  
Christopher Baird ◽  
Carlos Munoz-San Julian ◽  
Russell W. Jennings ◽  
...  
Keyword(s):  
At Risk ◽  
Cardiac Surgery ◽  
Recurrent Laryngeal Nerve ◽  
Pediatric Surgery ◽  
Tracheoesophageal Fistula ◽  
Laryngeal Nerve ◽  
Nerve Monitoring ◽  
Endotracheal Tubes ◽  
Surface Electrodes ◽  
Recurrent Laryngeal Nerve Monitoring

Objective: Review techniques for intraoperative recurrent laryngeal nerve (RLN) monitoring during pediatric surgery for esophageal atresia, tracheoesophageal fistula, tracheobronchomalacia, and cardiac surgery.Summary Background Data: Literature was reviewed for reports of intraoperative recurrent laryngeal nerve monitoring in cervical, thoracic, and cardiac surgical procedures which place the RLNs at risk for injury.Methods: Review paper.Results: The RLN is at risk during pediatric surgery for esophageal atresia, tracheoesophageal fistula, tracheobronchomalacia, and cardiac surgery. Intraoperative nerve monitoring has decreased rates of RLN injury in thyroid surgery. Intraoperative RLN monitoring techniques appropriate for pediatric surgery are discussed, including endotracheal tubes with integrated surface electrodes, adhesive surface electrodes for smaller endotracheal tubes, endolaryngeal electrodes, and automatic periodic continuous intra-operative stimulation.Conclusions: Multiple techniques exist to monitor the RLN in children undergoing cervical, cardiac, and thoracic surgery. Monitoring the RLN during procedures that place the RLNs at risk may help decrease the rate of RLN injury.

Superior Laryngeal Nerve Monitoring

2016 ◽  
pp. 201-220
Author(s):  
Gianlorenzo Dionigi ◽  
Cesare Carlo Ferrari ◽  
Alberto Mangano ◽  
Matteo Lavazza ◽  
Andrea Ieotta ◽  
...  
Keyword(s):  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Nerve Monitoring

External branch of the superior laryngeal nerve monitoring during thyroid and parathyroid surgery: International Neural Monitoring Study Group standards guideline statement

2013 ◽  
Vol 123 ◽  
pp. S1-S14 ◽  
Author(s):  
Marcin Barczyński ◽  
Gregory W. Randolph ◽  
Claudio R. Cernea ◽  
Henning Dralle ◽  
Gianlorenzo Dionigi ◽  
...  
Keyword(s):  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Study Group ◽  
Parathyroid Surgery ◽  
Nerve Monitoring ◽  
External Branch ◽  
Monitoring Study ◽  
Neural Monitoring

scholarly journals Recurrent and superior laryngeal nerve injury in thyroid surgery: literature review

2021 ◽  
Author(s):  
Abdullatif Mahyoub ◽  
Alaa A. Aljohani ◽  
Abdullah J. Althobaiti ◽  
Sami S. Alharbi ◽  
Abdulaziz A. Alahmary ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nerve Injury ◽  
Superior Laryngeal Nerve ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Nerve Monitoring ◽  
External Branch ◽  
Surgeon Experience ◽  
Laryngeal Nerve Injury ◽  
Intraoperative Nerve Monitoring

Laryngeal nerve injury is considered one of the most common complications after thyroidectomy. It is associated with decreased quality of life because it will result in hoarseness of voice and aspiration. Identification of the risk factors and procedures to decrease the injury is crucial for handling laryngeal nerve injury. We searched the MEDLINE database using PubMed. Two independent reviewers reviewed the resulting papers and reviewed them based on our inclusion criteria. Based on the review results, the incidence of recurrent laryngeal nerve injury is higher than the external branch of the superior laryngeal nerve, but it is mainly due to under-reporting of the external branch of superior laryngeal nerve injury. Cancer surgery, surgeon experience, workload, re-operative procedures, and extent of surgery increased the incidence of the laryngeal nerve injury. Handling of these risk factors combined with visual dissection and inspection and/or intraoperative nerve monitoring decreased the incidence of the nerve injury. In conclusion, laryngeal nerve injury is a common post thyroidectomy complication. Anatomical dissection and visual inspection combined with intraoperative nerve monitoring is the most suitable option in high-risk thyroid surgeries.

scholarly journals Intraoperative Monitoring of the Recurrent Laryngeal Nerve during Thyroidectomy: A Standardized Approach (Part 1)

2011 ◽  
Vol 3 (3) ◽  
pp. 144-150 ◽  
Author(s):  
Henning Dralle ◽  
Antonio Sitges-Serra ◽  
Peter Angelos ◽  
Manuel C Durán Poveda ◽  
Gianlorenzo Dionigi ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Thyroid Surgery ◽  
Superior Laryngeal Nerve ◽  
Surgical Anatomy ◽  
Laryngeal Nerve ◽  
Nerve Monitoring ◽  
Visual Identification ◽  
Current State ◽  
Monitoring Procedure ◽  
Intraoperative Nerve Monitoring

ABSTRACT One of the most feared complications in thyroid surgery is injury to the superior laryngeal nerve or recurrent laryngeal nerve. Neural identification during surgery is insufficient to assess nerve injury. Intraoperative nerve monitoring of the vagal nerve and recurrent laryngeal nerve during thyroid surgery is a new adjunct designed to allow better identification of nerves at risk and therefore reduce complications related to their injury. This new working tool does not substitute adequate surgical technique but merely provides the surgeon with an adjunct to routine visual identification and functional assessment. The use of nerve monitoring requires standardization of the monitoring procedure. Pursuant to this, we will discuss in two related articles the current state of the art standardized technique of nerve monitoring in thyroid surgery. The aim of part 1 is to provide a concise overview of nerve monitoring in thyroid surgery and its effectiveness. This will include a brief review of the surgical anatomy of the recurrent laryngeal nerve and the key landmarks used to identify the nerve during surgery. Part 2 will describe how to perform the standardized nerve monitoring in a step by step fashion during thyroid surgery which will diminish variable results and misleading information associated with a nonstandardized nerve monitoring procedure.

Pitfalls in intraoperative nerve monitoring during vestibular schwannoma surgery

2012 ◽  
Vol 33 (3) ◽  
pp. E5 ◽  
Author(s):  
Matthew L. Kircher ◽  
Jack M. Kartush
Keyword(s):  
Vestibular Schwannoma ◽  
Intraoperative Neurophysiological Monitoring ◽  
Neurophysiological Monitoring ◽  
Nerve Monitoring ◽  
Surgeon Training ◽  
Monitoring Process ◽  
Recurrent Laryngeal Nerves ◽  
American Society ◽  
Intraoperative Nerve Monitoring ◽  
American Society Of Anesthesiologists

Despite the widespread acceptance of intraoperative neurophysiological monitoring in skull base surgery over the last 2 decades, surgeon training in the technical and interpretive aspects of nerve monitoring has been conspicuously lacking. Inadequate fundamental knowledge of neurophysiological monitoring may lead to misinterpretations and an inability to troubleshoot system errors. Some surgeons perform both the technical and interpretive aspects of monitoring themselves while others enjoin coworkers (surgical residents, nurses, anesthetists, or a separate monitoring service) to perform the technical portion. Regardless, the surgeon must have a thorough understanding to avoid potential medical and legal pitfalls because poor monitoring is worse than no monitoring. A structured curriculum and protocol in both the technical and interpretive aspects of monitoring is recommended for all personnel involved in the monitoring process. This paper details the technical, interpretive, and surgical correlates necessary for optimal intraoperative nerve monitoring during vestibular schwannoma surgery with an emphasis on electromyographic monitoring for facial and recurrent laryngeal nerves. Just as the American Society of Anesthesiologists' 1986 “Standards for Basic Anesthetic Monitoring” became a useful tool for both patients and anesthesiologists, impending guidelines in intraoperative neurophysiological monitoring should likewise become an important instrument for optimizing intraoperative neurophysiological monitoring.

Recurrent laryngeal nerve monitoring with surface electrodes in pediatric thyroid surgery

2019 ◽  
Vol 130 (6) ◽  
pp. 1583-1589 ◽  
Author(s):  
Evan Jon Propst ◽  
Jonah Gorodensky ◽  
Jonathan Daniel Wasserman ◽  
Ethan Forde Glazman ◽  
Leona Ariel Tilis ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Thyroid Surgery ◽  
Laryngeal Nerve ◽  
Nerve Monitoring ◽  
Surface Electrodes ◽  
Recurrent Laryngeal Nerve Monitoring
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