scholarly journals Sutureless Thyroidectomy With Intraoperative Neuromonitoring and Energy-Based Device Without Sternotomy for Symptomatic Substernal Goiter Harboring Thyroiditis of Gland Parenchyma

Cureus ◽  
2021 ◽  
Author(s):  
Demet Sengul ◽  
Ilker Sengul ◽  
Tuncer Ozturk
Keyword(s):  
Intraoperative Neuromonitoring ◽  
Substernal Goiter

Wie nützlich ist das intraoperative Neuromonitoring bei Rezidiveingriffen an der Schilddrüse: eine retrospektiv vergleichende Analyse

2011 ◽  
Vol 49 (08) ◽  
Author(s):  
TM Rolfs ◽  
PF Alesina ◽  
S Hommeltenberg ◽  
J Hinrichs ◽  
B Meier ◽  
...  
Keyword(s):  
Intraoperative Neuromonitoring

Management particularities of substernal goiter

2018 ◽  
Author(s):  
Halwani Chiraz ◽  
Zoghlami Imene ◽  
Zgolli Cyrine ◽  
Akkari Khmaies ◽  
Ben Mhamed Rania
Keyword(s):  
Substernal Goiter

Intraoperative Neuromonitoring of the laryngeal nerves in thyroid surgery

2019 ◽  
Author(s):  
Mikhail O Vozdvizhenskii ◽  
AE Orlov ◽  
AA Makhonin ◽  
VV Stadler ◽  
Ya.S Matyash
Keyword(s):  
Thyroid Surgery ◽  
Intraoperative Neuromonitoring ◽  
Laryngeal Nerves

Introduction of intraoperative neuromonitoring does not necessarily improve overall long-term outcome in elective aneurysm clipping

2020 ◽  
Vol 132 (4) ◽  
pp. 1188-1196 ◽  
Author(s):  
Tobias Greve ◽  
Veit M. Stoecklein ◽  
Franziska Dorn ◽  
Sophia Laskowski ◽  
Niklas Thon ◽  
...  
Keyword(s):  
Evoked Potentials ◽  
Predictive Value ◽  
Neurological Outcome ◽  
Positive Impact ◽  
Case Series ◽  
Intraoperative Neuromonitoring ◽  
Neurosurgical Procedures ◽  
Long Term Outcome ◽  
Unruptured Intracranial Aneurysms ◽  
Significant Difference

OBJECTIVEIntraoperative neuromonitoring (IOM), particularly of somatosensory-evoked potentials (SSEPs) and motor-evoked potentials (MEPs), evolved as standard of care in a variety of neurosurgical procedures. Case series report a positive impact of IOM for elective microsurgical clipping of unruptured intracranial aneurysms (ECUIA), whereas systematic evaluation of its predictive value is lacking. Therefore, the authors analyzed the neurological outcome of patients undergoing ECUIA before and after IOM introduction to this procedure.METHODSThe dates of inclusion in the study were 2007–2014. In this period, ECUIA procedures before (n = 136, NIOM-group; 2007–2010) and after introduction of IOM (n = 138, IOM-group; 2011–2014) were included. The cutoff value for SSEP/MEP abnormality was chosen as an amplitude reduction ≥ 50%. SSEP/MEP changes were correlated with neurological outcome. IOM-undetectable deficits (bulbar, vision, ataxia) were not included in risk stratification.RESULTSThere was no significant difference in sex distribution, follow-up period, subarachnoid hemorrhage risk factors, aneurysm diameter, complexity, and location. Age was higher in the IOM-group (57 vs 54 years, p = 0.012). In the IOM group, there were 18 new postoperative deficits (13.0%, 5.8% permanent), 9 hemisyndromes, 2 comas, 4 bulbar symptoms, and 3 visual deficits. In the NIOM group there were 18 new deficits (13.2%; 7.3% permanent, including 7 hemisyndromes). The groups did not significantly differ in the number or nature of postoperative deficits, nor in their recovery rate. In the IOM group, SSEPs and MEPs were available in 99% of cases. Significant changes were noted in 18 cases, 4 of which exhibited postoperative hemisyndrome, and 1 suffered from prolonged comatose state (5 true-positive cases). Twelve patients showed no new detectable deficits (false positives), however 2 of these cases showed asymptomatic infarction. Five patients with new hemisyndrome and 1 comatose patient did not show significant SSEP/MEP alterations (false negatives). Overall sensitivity of SSEP/MEP monitoring was 45.5%, specificity 89.8%, positive predictive value 27.8%, and negative predictive value 95.0%.CONCLUSIONSThe assumed positive impact of introducing SSEP/MEP monitoring on overall neurological outcome in ECUIA did not reach significance. This study suggests that from a medicolegal point of view, IOM is not stringently required in all neurovascular procedures. However, future studies should carefully address high-risk patients with complex procedures who might benefit more clearly from IOM than others.

Intraoperative monitoring of olfactory function: a feasibility study

2020 ◽  
Vol 132 (5) ◽  
pp. 1659-1664 ◽  
Author(s):  
Shahan Momjian ◽  
Rémi Tyrand ◽  
Basile N. Landis ◽  
Colette Boëx
Keyword(s):  
Evoked Potentials ◽  
General Anesthesia ◽  
Intraoperative Neuromonitoring ◽  
Olfactory Function ◽  
Chemical Senses ◽  
Cerebral Lesions ◽  
Artifact Rejection ◽  
Rejection Criterion ◽  
Olfactory Stimuli ◽  
Anterior Fossa

OBJECTIVEIntraoperative neuromonitoring of the chemical senses (smell and taste) has never been performed. The objective of this study was to determine if olfactory-evoked potentials could be obtained intraoperatively under general anesthesia.METHODSA standard olfactometer was used in the surgical theater with hydrogen sulfide (4 ppm, 200 msec). Olfactory-evoked potentials were recorded in 8 patients who underwent neurosurgery for resection of cerebral lesions. These patients underwent routine target-controlled propofol and sufentanil general anesthesia. Frontal, temporal, and parietal scalp subdermal electrodes were recorded ipsilaterally and contralaterally at the site of the surgery. Evoked potentials were computed if at least 70 epochs (0.5–100 Hz) satisfying the artifact rejection criterion (threshold 45 μV) could be extracted from signals of electrodes.RESULTSContributive recordings were obtained for 5 of 8 patients (3 patients had fewer than 70 epochs with an amplitude < 45 μV). Olfactory-evoked potentials showed N1 responses (mean 442.8 ± 40.0 msec), most readily observed in the patient who underwent midline anterior fossa neurosurgery. No component of later latencies could be recorded consistently.CONCLUSIONSThe study confirms that olfactory-evoked potentials can be measured in response to olfactory stimuli under general anesthesia. This demonstrates the feasibility of recording olfactory function intraoperatively and opens the potential for neuromonitoring of olfactory function during neurosurgery.

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.

Anaesthesia and multimodality intraoperative neuromonitoring in carotid endarterectomy. Chronological evolution and effects on intraoperative neurophysiology

2021 ◽  
Author(s):  
Ana Mirallave Pescador ◽  
Pedro Javier Pérez Lorensu ◽  
Ángel Saponaro González ◽  
Beneharo Darias Delbey ◽  
José Luis Pérez Burkhardt ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Intraoperative Neuromonitoring ◽  
Intraoperative Neurophysiology

Anatomical and developmental aspects of iatrogenic injury to the right recurrent laryngeal nerve in surgical resections of substernal goiter

2021 ◽  
Author(s):  
Rossano Kepler Alvim Fiorelli ◽  
Alfredo Jorge Vasconcelos Duarte ◽  
Aline de Quadros Teixeira ◽  
Thiago Scharth Montenegro ◽  
Pedro Eder Portari Filho ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Iatrogenic Injury ◽  
Substernal Goiter ◽  
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