Hoon Yub Kim1, Ralph P Tufano2, Gregory Randolph3, Marcin Barczyński4, Che-Wei Wu5,6, Feng-Yu Chiang5,6, Xiaoli Liu7, Hiroo Masuoka8, Akira Miyauchi9, Soo Young Park9, Hee Yong Kwak1, Hye Yoon Lee1, Gianlorenzo Dionigi10. 1. Department of Surgery, KUMC Thyroid Center, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea. 2. Division of Head and Neck Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland. 3. Division of Thyroid and Parathyroid Endocrine Surgery, Department of Laryngology and Otology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts. 4. Department of General Surgery, Jagiellonian University, Medical College, Krakow, Poland. 5. Institute of Clinical Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. 6. Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. 7. Jilin Provincial Key Laboratory of Surgical Translational Medicine, Japan Union Hospital of Jilin University, Division of Thyroid Surgery, Changchun City, Jilin Province, China. 8. Department of Surgery, Kuma Hospital, Center for Excellence in Thyroid Care, Kobe, Japan. 9. Department of Anesthesiology, Korea University College of Medicine, Seoul, Korea. 10. First Division of Surgery, Research Center for Endocrine Surgery, Department of Surgical Sciences and Human Morphology, University of Insubria (Como-Varese), Varese, Italy.
Abstract
BACKGROUND: The purpose of this study was to evaluate electromyography (EMG) amplitude and latency changes during tube dislocation in monitored thyroid surgery, which may be observed without recurrent laryngeal nerve injury. METHODS: Duroc-Landrace piglets were intubated with the TriVantage EMG tube. We measured EMG changes during both upward and downward tube dislocation (10-20 mm) and rotation (45-90°) with continuous neuromonitoring. RESULTS: The EMG amplitude varied significantly with induced endotracheal tube rotation and depth changes. However, the EMG latency was relatively unaffected by such tube dislocation, just a transient artifactual latency change was observed in the situation of extreme amplitude variation. CONCLUSION: Amplitude changes without latency changes may be due to changes in tube position alone during surgery, but could still reflect a neurophysiologic event; amplitude changes during neuropraxic injury merit additional investigation. Thus, the combined event (concordant amplitude decrease and latency increase) serves as an appropriate adverse EMG event correlating with impending neural injury.
BACKGROUND: The purpose of this study was to evaluate electromyography (EMG) amplitude and latency changes during tube dislocation in monitored thyroid surgery, which may be observed without recurrent laryngeal nerve injury. METHODS: Duroc-Landrace piglets were intubated with the TriVantage EMG tube. We measured EMG changes during both upward and downward tube dislocation (10-20 mm) and rotation (45-90°) with continuous neuromonitoring. RESULTS: The EMG amplitude varied significantly with induced endotracheal tube rotation and depth changes. However, the EMG latency was relatively unaffected by such tube dislocation, just a transient artifactual latency change was observed in the situation of extreme amplitude variation. CONCLUSION: Amplitude changes without latency changes may be due to changes in tube position alone during surgery, but could still reflect a neurophysiologic event; amplitude changes during neuropraxic injury merit additional investigation. Thus, the combined event (concordant amplitude decrease and latency increase) serves as an appropriate adverse EMG event correlating with impending neural injury.
Authors: Sam Van Slycke; K Van Den Heede; K Magamadov; N Brusselaers; H Vermeersch Journal: Langenbecks Arch Surg Date: 2019-11-20 Impact factor: 3.445
Authors: Jongjin Kim; Hyeon Jong Moon; Young Jun Chai; Jung-Man Lee; Ki-Tae Hwang; Che-Wei Wu; Gianlorenzo Dionigi; Hoon Yub Kim; Kyung Sik Park; Sang Wan Kim; Ka Hee Yi Journal: Int J Endocrinol Date: 2020-01-30 Impact factor: 3.257