OBJECTIVE: To determine whether nerve integrity monitor testing during thyroidectomy predicts recurrent laryngeal nerve (RLN) function after surgery. DESIGN: Prospective cohort outcomes study PATIENTS: The study included 210 consecutive patients with thyroid abnormalities who underwent thyroidectomy. METHODS: All patients were intraoperatively monitored with a nerve integrity monitoring system (Xomed NIM II; Medtronic Inc, Fridley, Minnesota), and their vocal cord function was assessed with fiberoptic laryngoscopy before and after surgery. Normal and impaired vocal cord function were compared using an independent t test with respect to postoperative vocal cord mobility, length of the RLN dissection, and the minimum stimulus needed to generate a response at the completion of surgery. RESULTS: There was a statistically significant difference between the stimulus in milliamperes required to stimulate normal vs abnormal functioning nerves at the completion of the procedure at the cricoarytenoid joint (P = .02) and at the distal end of the RLN dissection (P < .01). A greater length of dissected nerve was associated with normal vocal cord function; however, it was not statistically significant (P = .07). CONCLUSION: These data suggest that an RLN that responds at lower-intensity stimulation (</=0.5 mA) at the end of thyroid surgery is associated with normal vocal cord mobility.
OBJECTIVE: To determine whether nerve integrity monitor testing during thyroidectomy predicts recurrent laryngeal nerve (RLN) function after surgery. DESIGN: Prospective cohort outcomes study PATIENTS: The study included 210 consecutive patients with thyroid abnormalities who underwent thyroidectomy. METHODS: All patients were intraoperatively monitored with a nerve integrity monitoring system (Xomed NIM II; Medtronic Inc, Fridley, Minnesota), and their vocal cord function was assessed with fiberoptic laryngoscopy before and after surgery. Normal and impaired vocal cord function were compared using an independent t test with respect to postoperative vocal cord mobility, length of the RLN dissection, and the minimum stimulus needed to generate a response at the completion of surgery. RESULTS: There was a statistically significant difference between the stimulus in milliamperes required to stimulate normal vs abnormal functioning nerves at the completion of the procedure at the cricoarytenoid joint (P = .02) and at the distal end of the RLN dissection (P < .01). A greater length of dissected nerve was associated with normal vocal cord function; however, it was not statistically significant (P = .07). CONCLUSION: These data suggest that an RLN that responds at lower-intensity stimulation (</=0.5 mA) at the end of thyroid surgery is associated with normal vocal cord mobility.
Authors: Mario Testini; Francesco Logoluso; Germana Lissidini; Angela Gurrado; Giuseppe Campobasso; Rocco Cortese; Giuseppe Massimiliano De Luca; Ilaria Fabiola Franco; Alessandro De Luca; Giuseppe Piccinni Journal: World J Emerg Surg Date: 2012-04-11 Impact factor: 5.469
Authors: David Calligaris; Diana Caragacianu; Xiaohui Liu; Isaiah Norton; Christopher J Thompson; Andrea L Richardson; Mehra Golshan; Michael L Easterling; Sandro Santagata; Deborah A Dillon; Ferenc A Jolesz; Nathalie Y R Agar Journal: Proc Natl Acad Sci U S A Date: 2014-09-22 Impact factor: 11.205