Electrophysiologic recurrent laryngeal nerve monitoring during thyroid and parathyroid surgery: international standards guideline statement.
نویسندگان
چکیده
Intraoperative neural monitoring (IONM) during thyroid and parathyroid surgery has gained widespread acceptance as an adjunct to the gold standard of visual nerve identification. Despite the increasing use of IONM, review of the literature and clinical experience confirms there is little uniformity in application of and results from nerve monitoring across different centers. We provide a review of the literature and cumulative experience of the multidisciplinary International Neural Monitoring Study Group with IONM spanning nearly 15 years. The study group focused its initial work on formulation of standards in IONM as it relates to important areas: 1) standards of equipment setup/endotracheal tube placement and 2) standards of loss of signal evaluation/intraoperative problem-solving algorithm. The use of standardized methods and reporting will provide greater uniformity in application of IONM. In addition, this report clarifies the limitations of IONM and helps identify areas where additional research is necessary. This guideline is, at its forefront, quality driven; it is intended to improve the quality of neural monitoring, to translate the best available evidence into clinical practice to promote best practices. We hope this work will minimize inappropriate variations in monitoring rather than to dictate practice options.
منابع مشابه
External branch of the superior laryngeal nerve monitoring during thyroid and parathyroid surgery: International Neural Monitoring Study Group standards guideline statement.
UNLABELLED Intraoperative neural monitoring (IONM) during thyroid surgery has gained widespread acceptance as an adjunct to the gold standard of visual identification of the recurrent laryngeal nerve (RLN). Contrary to routine dissection of the RLN, most surgeons tend to avoid rather than routinely expose and identify the external branch of the superior laryngeal nerve (EBSLN) during thyroidect...
متن کاملProtective effect of intraoperative nerve monitoring against recurrent laryngeal nerve injury during re-exploration of the thyroid
BACKGROUND Previous thyroid or parathyroid surgery induces scarring or distorts anatomy, and increases the risk of recurrent laryngeal nerve (RLN) injury for a reoperation. The benefit of intraoperative nerve monitoring (IONM) for re-exploration (a second nerve exploration) and reoperation has not been established. METHODS Two hundred and ten patients were given a thyroid or parathyroid reope...
متن کاملLetter to the editor regarding cardiac arrest with vagal stimulation during intraoperative nerve monitoring.
BACKGROUND Intraoperative neuromonitoring (IONM) is widely used during thyroid surgery. During both intermittent and continuous IONM stimulation of the vagus nerve is performed. This has previously been reported to be safe. METHODS We present our findings based on the case reports of 2 patients. RESULTS IONM of the recurrent laryngeal nerve (RLN), following the standards of the Internationa...
متن کاملThe nonrecurrent laryngeal nerve: anatomic and electrophysiologic algorithm for reliable identification.
OBJECTIVES/HYPOTHESIS The recurrent laryngeal nerve (RLN) intraoperative monitoring (IONM) provides a new functional dynamic that adds to visual identification of the RLN to optimize its intraoperative management. Intraoperative monitoring has been applied to the initial identification of the RLN. We now apply IONM to the identification of the nonrecurrent laryngeal nerve (NRLN) and provide ele...
متن کاملIntraoperative electrophysiologic monitoring of the recurrent laryngeal nerve during thyroid and parathyroid surgery: Experience with 1,381 nerves at risk.
OBJECTIVES The electrophysiologic responses of 1,381 recurrent laryngeal nerves (RLN) during monitored neck surgery were recorded and reviewed. STUDY DESIGN Retrospective case series. METHODS With institutional review board approval, we reviewed thyroid and other neck surgeries performed with intraoperative nerve monitoring (IONM) between the years 1995 and 2006. This list yielded consecuti...
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ورودعنوان ژورنال:
- The Laryngoscope
دوره 121 Suppl 1 شماره
صفحات -
تاریخ انتشار 2011