Electromyographic response persists after peripheral transection: endorsement of current concepts in recurrent laryngeal nerve monitoring in a porcine model.

Langenbeck's Archives of Surgery
Torsten BirkholzJoachim Schmidt

Abstract

Recurrent laryngeal nerve palsy is a serious complication of endocrine surgery to the neck. Permanent lesions are still occurring in about one in a hundred, despite standardized surgical approach to the nerve and the availability of recurrent laryngeal nerve monitoring. Intraoperative recurrent laryngeal nerve monitoring is based on the visual or acoustic registration of evoked electromyography of the laryngeal muscles. Primarily, it proves conductivity of the stimulated nerve segment towards the muscle, so that stimulation distal of the lesion should show persistent electromyographic response. In a porcine model, an iatrogenic nerve lesion of the recurrent laryngeal nerve was set. Subsequently, the proximal and distal dissected nerve portion was stimulated and the evoked electromyographic response of the laryngeal muscles was recorded by needle and laryngeal surface electrodes. As expected, no signal was obtained from the proximal segment. Meanwhile, the distal segment showed unchanged amplitude of the electrophysiological response for the observation period of more than 1 h. This result demonstrated a remarkable pitfall for the neuromuscular monitoring at the recurrent laryngeal nerve: In the human surgical setting, this migh...Continue Reading

References

Jun 30, 2000·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·T M HemmerlingP Klein
Sep 16, 2000·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·T M HemmerlingK E Jacobi
Sep 26, 2002·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·J JonasR Bähr
Jan 15, 2004·Langenbeck's Archives of Surgery·Oliver ThomuschHenning Dralle
Oct 1, 2004·World Journal of Surgery·Gregory W RandolphJamie Wilkins
Apr 5, 2005·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Ronald C PearlmanAjit Shah
Apr 5, 2005·The Laryngoscope·Lisa Danielle GrunebaumEdmund A Pribitkin
May 15, 2007·ANZ Journal of Surgery·Thorbjorn J Loch-WilkinsonLeigh W Delbridge
Jul 20, 2007·Acta Anaesthesiologica Scandinavica·T Fuchs-BuderUNKNOWN 8th International Neuromuscular Meeting
Dec 25, 2007·Journal of the American College of Surgeons·Samuel K SnyderJohn W Roberts

❮ Previous
Next ❯

Citations

Jan 10, 2012·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Petros V VlastarakosGeorge Mochloulis
Apr 2, 2011·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·W LamadéK P Thon
Jul 12, 2011·Surgical Innovation·Wolfram LamadéKlaus-Peter Thon
Sep 2, 2016·Current Opinion in Endocrinology, Diabetes, and Obesity·Ivy H GardnerDavid McAneny

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiac Conduction System

The cardiac conduction system is a specialized tract of myocardial cells responsible for maintaining normal cardiac rhythm. Discover the latest research on the cardiac conduction system here.