Real-time laryngeal electromyographic monitoring of recurrent laryngeal nerve during thyroid reoperation

doi:10.3877/cma.j.issn.1674-0793.2014.01.002

Abstract

Abstract:

Objective

To assess the usage and value of monitoring the recurrent laryngeal nerve(RLN) during thyroid surgery by real-time laryngeal electromyography.

Methods

Fifty-five patients were under general anesthesia and thyroid reoperation. NIM-Response^TM electromyographic (EMG) monitor system was used for assistance of dissection, exposure and protection of the RLN during the surgical procedures.

Results

There were 107 RLNs exposed during the surgeries in all 55 patients. The unilateral RLN injured in 4 patients were also explored, among them 3 injuries were caused by transection, and 1 by ligation, which was detected precisely and released, the EMG recovered intraoperation and the vocal cord function recovered postoperation. The EMG of two successfully revealed RLN disappeared during surgical procedures, temporary vocal cord paralysis occurred and recovered in two months, the temporary palsy rate was 3.64% (2/55).

Conclusions

EMG monitor system is sensitive and accurate for explosing and preserving the RLN during thyroid reoperation. It is valuable for detecting the injury causes of RLN and predicting the postoperative function of vocal cord. This system deserves general utilization for thyroid surgery, especially for reoperation.

Key words: Recurrent laryngeal nerve, Thyroid, Reoperation, Real-time monitoring

Hua Jiang, Xi Li, Renbin Liu, Wanshou Qiu, Ruilei Liu, Juekun Wu, Zenan Huang, Yong Huang. Real-time laryngeal electromyographic monitoring of recurrent laryngeal nerve during thyroid reoperation[J]. Chinese Archives of General Surgery(Electronic Edition), 2014, 08(01): 4-7.

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References 11

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