BACKGROUND: Vagal nerve stimulation (VNS) has been recommended as a routine procedure during intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN). However, many surgeons have been discouraged from performing VNS because of the need for opening the carotid sheath. The purpose of this study was to investigate the feasibility and reliability of VNS without carotid sheath dissection. METHODS: Two hundred twenty patients with 376 nerves at risk were enrolled in this study. VNS without nerve exposure during IONM was applied by simply pressing a ball-tip stimulator on the space between the carotid artery and jugular vein. RESULTS: VNS without nerve exposure was feasible in all cases and did not result in any morbidity. All VNS signals were successfully obtained within 30 minutes of the start of the operation and all showed a clear and reliable laryngeal electromyography (EMG) response that was similar to that from the conventional method in which nerve exposure for VNS is applied. CONCLUSIONS: VNS without dissecting the carotid sheath is feasible and reliable, rendering it a simple, safe, and surgeon-friendly procedure during IONM.
BACKGROUND: Vagal nerve stimulation (VNS) has been recommended as a routine procedure during intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN). However, many surgeons have been discouraged from performing VNS because of the need for opening the carotid sheath. The purpose of this study was to investigate the feasibility and reliability of VNS without carotid sheath dissection. METHODS: Two hundred twenty patients with 376 nerves at risk were enrolled in this study. VNS without nerve exposure during IONM was applied by simply pressing a ball-tip stimulator on the space between the carotid artery and jugular vein. RESULTS: VNS without nerve exposure was feasible in all cases and did not result in any morbidity. All VNS signals were successfully obtained within 30 minutes of the start of the operation and all showed a clear and reliable laryngeal electromyography (EMG) response that was similar to that from the conventional method in which nerve exposure for VNS is applied. CONCLUSIONS: VNS without dissecting the carotid sheath is feasible and reliable, rendering it a simple, safe, and surgeon-friendly procedure during IONM.
Authors: Gianlorenzo Dionigi; Davide Lombardi; Celestino Pio Lombardi; Paolo Carcoforo; Marco Boniardi; Nadia Innaro; Maria Grazia Chiofalo; Ottavio Cavicchi; Antonio Biondi; Francesco Basile; Angelo Zaccaroni; Alberto Mangano; Andrea Leotta; Matteo Lavazza; Pietro Giorgio Calò; Angelo Nicolosi; Paolo Castelnuovo; Piero Nicolai; Luciano Pezzullo; Giorgio De Toma; Rocco Bellantone; Rosario Sacco Journal: Updates Surg Date: 2014-12-03
Authors: Dana M Hartl; Sophie Bidault; Elizabeth Girard; Joanne Guerlain; Ingrid Breuskin; Livia Lamartina; Marie Terroir; Sophie Leboulleux Journal: Eur Radiol Date: 2020-11-25 Impact factor: 5.315