Recurrent laryngeal nerve safety parameters of the Harmonic Focus during thyroid surgery: Porcine model using continuous monitoring

2015 ◽  
Vol 125 (12) ◽  
pp. 2838-2845 ◽  
Author(s):  
Che-Wei Wu ◽  
Young Jun Chai ◽  
Gianlorenzo Dionigi ◽  
Feng-Yu Chiang ◽  
Xiaoli Liu ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Thyroid Surgery ◽  
Continuous Monitoring ◽  
Porcine Model ◽  
Laryngeal Nerve ◽  
Harmonic Focus ◽  
Safety Parameters

scholarly journals Continuous monitoring of the recurrent laryngeal nerve in thyroid surgery: a critical appraisal

2013 ◽  
Vol 11 ◽  
pp. S44-S46 ◽  
Author(s):  
Gianlorenzo Dionigi ◽  
Gianluca Donatini ◽  
Luigi Boni ◽  
Stefano Rausei ◽  
Francesca Rovera ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Thyroid Surgery ◽  
Continuous Monitoring ◽  
Critical Appraisal ◽  
Laryngeal Nerve

Safety of LigaSure in recurrent laryngeal nerve dissection-porcine model using continuous monitoring

2016 ◽  
Vol 127 (7) ◽  
pp. 1724-1729 ◽  
Author(s):  
Gianlorenzo Dionigi ◽  
Feng-Yu Chiang ◽  
Hoon Yub Kim ◽  
Gregory W. Randolph ◽  
Alberto Mangano ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Continuous Monitoring ◽  
Porcine Model ◽  
Laryngeal Nerve

scholarly journals Improving Voice Outcomes After Thyroid Surgery – Review of Safety Parameters for Using Energy-Based Devices Near the Recurrent Laryngeal Nerve

2021 ◽  
Vol 12 ◽  
Author(s):  
Jia Joanna Wang ◽  
Tzu-Yen Huang ◽  
Che-Wei Wu ◽  
Yi-Chu Lin ◽  
Hsin-Yi Tseng ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Thyroid Surgery ◽  
Thermal Injury ◽  
Operation Time ◽  
Laryngeal Nerve ◽  
Cooling Time ◽  
Technological Advances ◽  
Standard Procedures ◽  
Thermal Spread ◽  
Safety Parameters

Technological advances in thyroid surgery have rapidly increased in recent decades. Specifically, recently developed energy-based devices (EBDs) enable simultaneous dissection and sealing tissue. EBDs have many advantages in thyroid surgery, such as reduced blood loss, lower rate of post-operative hypocalcemia, and shorter operation time. However, the rate of recurrent laryngeal nerve (RLN) injury during EBD use has shown statistically inconsistent. EBDs generate high temperature that can cause iatrogenic thermal injury to the RLN by direct or indirect thermal spread. This article reviews relevant medical literatures of conventional electrocauteries and different mechanisms of current EBDs, and compares two safety parameters: safe distance and cooling time. In general, conventional electrocautery generates higher temperature and wider thermal spread range, but when applying EBDs near the RLN adequate activation distance and cooling time are still required to avoid inadvertent thermal injury. To improve voice outcomes in the quality-of-life era, surgeons should observe safety parameters and follow the standard procedures when using EBDs near the RLN in thyroid surgery

INTRAOPERATIVE CONTINUOUS NEUROMONITORING OF LARYNGEAL RECCURENT NERVES IN PATIENTS WITH THYROID CANCER

2019 ◽  
Vol 65 (3) ◽  
pp. 342-348
Author(s):  
Viktor Makarin ◽  
Anna Uspenskaya ◽  
Arseniy Semenov ◽  
Natalya Timofeeva ◽  
Roman Chernikov ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Postoperative Complications ◽  
Recurrent Laryngeal Nerve ◽  
Thyroid Surgery ◽  
Intraoperative Neuromonitoring ◽  
Laryngeal Nerve ◽  
Laryngeal Muscles ◽  
Neural Transmission ◽  
Continuous Neuromonitoring ◽  
Surgical Manipulation

Laryngeal muscles paresis ranks second in prevalence of postoperative complications after thyroid surgery. Intraoperative neuromonitoring (IONM) of recurrent laryngeal nerve (RLN) results in reduction of cases with dysphonia and prevents such severe complication as bilateral paresis. Currently there are two types of monitoring: intermittent and continual. When using intermittent IONM surgeon has no opportunity to control electrophysiology state of RLN during intervals between stimulations. In case of continual IONM date on amplitude and latency are available to surgeon in real time every second, allowing him instantly react to any disturbance of neural transmission to prevent its damage by changing surgical manipulation. This work presents the first experience of using continual neuromonitoring of RLN in Russia, the procedure is described in details its safety. It is represented the possibility of prevention of bilateral laryngeal muscles paresis.

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