Sameep Kadakia1, Moustafa Mourad2, Arvind Badhey3, Thomas Lee4, Manlio Gessaroli5, Yadranko Ducic2. 1. New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA. sameep8779@gmail.com. 2. Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, TX, USA. 3. New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA. 4. Virginia Commonwealth University Hospital, Richmond, VA, USA. 5. Maxillofacial Surgery, Bufalini Hospital, Cesena, Italy.
Abstract
PURPOSE: To determine the utility of intraoperative nerve monitoring (IONM) during tracheal resection or slide tracheoplasty to prevent recurrent laryngeal nerve injury. METHODS: 110 patients underwent tracheal resection or tracheoplasty between 1997 and 2016. During the first 10-year period, IONM was not used while during the second 10-year period, IONM was used. 49 patients had surgery without IONM while 61 had surgery with IONM. During the post-operative period, patients with nerve injury were compared to determine if significant difference existed between the two modalities. RESULTS: In patients who had surgery without IONM, 7 (14.2%) patients were found to have compromised nerve function whereas 8 (13.1%) patients in the group with IONM had nerve injury. 3 patients regained function in the first group while four regained function in the second. A Fisher's exact test was run on the entire cohort and the difference in vocal fold injury was not found to be statistically significant (p > 0.05). CONCLUSION: Based on this single surgeon experience, there may be no protective benefit with the use of IONM during tracheal surgery.
PURPOSE: To determine the utility of intraoperative nerve monitoring (IONM) during tracheal resection or slide tracheoplasty to prevent recurrent laryngeal nerve injury. METHODS: 110 patients underwent tracheal resection or tracheoplasty between 1997 and 2016. During the first 10-year period, IONM was not used while during the second 10-year period, IONM was used. 49 patients had surgery without IONM while 61 had surgery with IONM. During the post-operative period, patients with nerve injury were compared to determine if significant difference existed between the two modalities. RESULTS: In patients who had surgery without IONM, 7 (14.2%) patients were found to have compromised nerve function whereas 8 (13.1%) patients in the group with IONM had nerve injury. 3 patients regained function in the first group while four regained function in the second. A Fisher's exact test was run on the entire cohort and the difference in vocal fold injury was not found to be statistically significant (p > 0.05). CONCLUSION: Based on this single surgeon experience, there may be no protective benefit with the use of IONM during tracheal surgery.
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