Anterior laryngeal electrodes for recurrent laryngeal nerve monitoring during thyroid and parathyroid surgery: New expanded options for neural monitoring

2018 ◽  
Vol 128 (12) ◽  
pp. 2910-2915 ◽  
Author(s):  
Whitney Liddy ◽  
Bradley R. Lawson ◽  
Samuel R. Barber ◽  
Dipti Kamani ◽  
Mohamed Shama ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Parathyroid Surgery ◽  
Nerve Monitoring ◽  
Neural Monitoring ◽  
Recurrent Laryngeal Nerve Monitoring

scholarly journals Electrophysiologic recurrent laryngeal nerve monitoring during thyroid and parathyroid surgery: International standards guideline statement

2010 ◽  
Vol 121 (S1) ◽  
pp. S1-S16 ◽  
Author(s):  
Gregory W. Randolph ◽  
Henning Dralle ◽  
Hisham Abdullah ◽  
Marcin Barczynski ◽  
Rocco Bellantone ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
International Standards ◽  
Parathyroid Surgery ◽  
Nerve Monitoring ◽  
Recurrent Laryngeal Nerve Monitoring

scholarly journals Experience of Intraoperative Recurrent Laryngeal Nerve monitoring in a Single Center-normative Recurrent Laryngeal Nerve Electromyographic Data

2017 ◽  
Vol 9 (1) ◽  
pp. 1-6
Author(s):  
Rajeev Parameswaran ◽  
Gilbert Soh ◽  
James Wai Kit Lee ◽  
Oh Han Boon ◽  
Tan Wee Boon ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Parathyroid Surgery ◽  
Nerve Monitoring ◽  
Number Of Patients ◽  
Significant Difference ◽  
Hoarse Voice ◽  
Stimulation Current ◽  
The Right ◽  
Recurrent Laryngeal Nerve Monitoring

ABSTRACT Introduction Injury to the recurrent laryngeal nerve (RLN) remains a significant morbidity during thyroid and parathyroid surgery. The aim of this study is to elucidate normative RLN electromyographic (EMG) parameters. Materials and methods This is a retrospective cohort study of patients who underwent Intraoperative neuromonitoring during thyroid and parathyroid surgery from February 2014 to March 2015. The inomed C2 NerveMonitor was used. We recorded the stimulation current, amplitude, and latency of the RLN before and after nerve dissection. We also observed the number of patients who had hoarse voice after surgery. Results A total of 46 patients (14 male, 32 female) averaging 51 years old in age (20-77 years) were analyzed. The most commonly performed surgical procedure was total thyroidectomy (53.2%). The median stimulation current for both the right and left RLN was 0.500 mA. The median amplitude for the left RLN was 1.060 mV and greater than that for the right RLN (0.930 mV) (p = 0.30). The median latency for the right RLN and left RLN was 2.40 ms with no difference between the sides. (p = 0.58). Post dissection, the right RLN amplitude remained identical whereasthe left RLN amplitude decreased. Latencies of both RLNs decreased although the difference was not significant. Nature of pathology and site of surgery did not influence RLN latency and amplitude. No patients had hoarse voice. Conclusion This study highlights the normative EMG parameters for bilateral RLN nerve stimulation in an Asian population. No significant difference was noted in both pre- and postdissection RLN EMG parameters. How to cite this article Soh G, Lee JWK, Boon OH, Boon TW, Parameswaran R, Yuan NK. Experience of Intraoperative Recurrent Laryngeal Nerve monitoring in a Single Centernormative Recurrent Laryngeal Nerve Electromyographic Data. World J Endoc Surg 2017;9(1):1-6.

scholarly journals Intraoperative recurrent laryngeal nerve monitoring using endotracheal electromyography during parathyroidectomy for secondary hyperparathyroidism

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052110009
Author(s):  
Takahisa Hiramitsu ◽  
Toshihide Tomosugi ◽  
Manabu Okada ◽  
Kenta Futamura ◽  
Norihiko Goto ◽  
...  
Keyword(s):  
Secondary Hyperparathyroidism ◽  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Parathyroid Gland ◽  
Vocal Cord Paralysis ◽  
Laryngeal Nerve ◽  
Nerve Monitoring ◽  
Nodular Hyperplasia ◽  
Neural Monitoring ◽  
Recurrent Laryngeal Nerve Monitoring

Objective To investigate the factors associated with adherence of an enlarged parathyroid gland to the recurrent laryngeal nerve (RLN) and the effectiveness of intraoperative neural monitoring (IONM). Methods This single-center retrospective study involved samples from 197 consecutive patients (394 RLNs; 733 parathyroid glands) who underwent parathyroidectomy and transcervical thymectomy between September 2010 and December 2014. The presence of parathyroid gland adhesion to the RLN and the clinical characteristics of patients with and without nerve adhesion were recorded. All patients underwent intraoperative monitoring of the electromyographic responses of the vocal cords using the endotracheal NIM-Response 3.0 system. The patients’ postoperative clinical outcomes were recorded. Results Parathyroid gland adhesion to the RLN was significantly associated with maximum gland diameter (>15 mm), weight (>500 mg), and the presence of nodular hyperplasia. IONM demonstrated a sensitivity of 97.8%, specificity of 43.5%, and accuracy of 94.7% for detecting nerve damage. Parathyroid gland adhesion to 17 RLNs occurred in 3 cases (17.6%) of vocal cord paralysis, whereas the 377 glands without nerve adhesion resulted in vocal cord paralysis in 20 cases (5.3%). Conclusion Our findings demonstrated the effectiveness of IONM using endotracheal electromyography in patients who underwent parathyroidectomy for secondary hyperparathyroidism.

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