reported their comprehensive experience in intraoperative neuromonitoring (IONM) in thyroid surgery. I have carefully read this excellent paper. Certainly, these colleagues have made several contributions to the literature, and their valuable contributions have advanced our understanding of the surg
Transcricothyroid electromyographic monitoring of the recurrent laryngeal nerve
β Scribed by Eran E. Alon; Michael L. Hinni
- Publisher
- John Wiley and Sons
- Year
- 2009
- Tongue
- English
- Weight
- 316 KB
- Volume
- 119
- Category
- Article
- ISSN
- 0023-852X
No coin nor oath required. For personal study only.
β¦ Synopsis
Abstract
Objectives/Hypothesis:
To determine the usefulness of intraoperative nerve monitoring using an electrode placed in the midline through the cricothyroid membrane.
Study Design:
Retrospective records review.
Methods:
Patients of the otolaryngology department of our tertiary care academic medical center were identified if they had undergone either total thyroidectomy or total thyroid lobectomy accompanied by bilateral electromyographic (EMG) monitoring of the recurrent laryngeal nerve (RLN) between January 2007 and October 2007.
Results:
Fortyβthree patients were identified who had a total throidectomy or a total thyroid lobectomy. Nineteen of the 43 had intraoperative EMG monitoring of the RLN with placement of a single EMG electrode through the cricothyroid membrane; 11 had a thyroidectomy, and eight had a thyroid lobectomy. Overall, 30 atβrisk nerves were stimulated with an EMG probe; 27 responded adequately and three (paralyzed before surgery) were unresponsive.
Conclusions:
Central placement of an EMG electrode through the cricothyroid membrane into the thyroarytenoid musculature is a safe and reliable technique for bilateral monitoring of the RLN that facilitates evaluation of postoperative function. Laryngoscope, 2009
π SIMILAR VOLUMES
There were 79 right and 65 left nerves dissected (N=144). On the right, the mean length of the dissection was 27.72 mm and on the left 31.40 mm. (Table 1). The length of the dissection ranged from 7-65 mm on the right and 3-62 mm on the patients left side. The mean distance from the TE groove was 4.
An incidental finding in the anatomy lab showed up a plexus of the external branch of the right superior laryngeal nerve (SLN), including an anastomosis with the recurrent laryngeal nerve (RLN). The external branch of the SLN divided in two extensions: The ventral extension reached the mesopharynx l