Surgical anatomy and neurophysiology of the vagus nerve (VN) for standardised intraoperative neuromonitoring (IONM) of the inferior laryngeal nerve (ILN) during thyroidectomy.

Langenbeck's Archives of Surgery
Gianlorenzo DionigiAlessandro Bacuzzi

Abstract

Standardisation of the intraoperative neuromonitoring (IONM) technique is a fundamental aspect in monitored thyroid surgery. Vagal nerve (VN) stimulation is essential for problem solving, recognition of any inferior laryngeal nerve (ILN) lesions and prediction of ILN post-operative function. Issues that have been overlooked in the literature, particularly in terms of prospective approaches, are the topographic relationship of the VN with the carotid and jugular vessels as well as the neurophysiology of the VN and ILN that have been studied, with a prospective approach, in patients with various thyroid diseases. Cooperation with the Human Morphology Department resulted in the completion of a dedicated anatomy report, with the clear objective of providing a detailed anatomic and neurophysiologic description of the VN (n = 263). VN identification and stimulation was feasible in all cases and did not result in increased morbidity or operative time. Most VNs lay on the posterior region of the carotid ship (73%), i.e. the P position in accordance with our model. Mean amplitudes of EMG signals obtained from VN stimulation were 750 ± 279 μV, lower than those obtained with direct INL stimulation (1,086 ± 349 μV). A better understanding ...Continue Reading

References

Jul 4, 2002·American Journal of Surgery·Oliver ThomuschHenning Dralle
Oct 1, 2004·World Journal of Surgery·Gregory W RandolphJamie Wilkins
Feb 29, 2008·World Journal of Surgery·H DralleUNKNOWN German IONM Study Group
Jan 2, 2009·International Journal of Surgery·G DionigiR Dionigi
Apr 3, 2010·American Journal of Surgery·Rick SchneiderSteffen Leinung

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Citations

Aug 17, 2010·Langenbeck's Archives of Surgery·Bruno Niederle
Mar 6, 2013·Langenbeck's Archives of Surgery·Sam Van SlyckeHubert Vermeersch
Dec 4, 2014·Updates in Surgery·Gianlorenzo DionigiUNKNOWN Working Group for Neural Monitoring in Thyroid and Parathyroid Surgery in Italy
Dec 18, 2013·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·H DralleUNKNOWN Surgical Working Group for Endocrinology
Sep 21, 2013·Revista española de anestesiología y reanimación·J L Pardal-RefoyoC Ochoa-Sangrador
Nov 12, 2013·Neuroimaging Clinics of North America·Theodoros SoldatosAvneesh Chhabra
Jun 2, 2012·Acta otorrinolaringológica española·José Luis Pardal-Refoyo
Dec 29, 2015·International Journal of Surgery·Pietro Giorgio CalòAngelo Nicolosi
Feb 14, 2015·PloS One·Niels HammerDirk Winkler
Feb 2, 2017·Neuromodulation : Journal of the International Neuromodulation Society·Uwe PlanitzerDirk Winkler
Apr 5, 2017·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Behzad SalariGregory W Randolph
Jan 21, 2017·Langenbeck's Archives of Surgery·Liu XiaoliMatteo Lavazza
Mar 26, 2020·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Yishen ZhaoHui Sun
May 16, 2013·Annals of Surgery·Gianlorenzo DionigiAlberto Mangano
May 11, 2018·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Daqi ZhangHui Sun
Jul 25, 2021·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Jason LabuschagneClaudia Casieri
Sep 30, 2021·World Neurosurgery·Coby J Cunningham, Jaime L Martínez

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