Background Continuous intraoperative neuromonitoring (C-IONM) is a new technology and it is appropriate to analyze its safety. Methods C-IONM was performed according to a standardized technique to control any adverse events and electrode positioning issues. Results Four hundred vagal nerve dissections were analyzed considering vagal nerve diameter, mean time effort for C-IONM probe positioning, and electrode dislocation rate. A significant superior dislocation rate in case of: (a) when a 3 mm automatic periodic stimulating (APS) electrode size was used in a vagal nerve diameter <2 mm; (b) anterior access; and (c) vagal nerve A subtype in relation (p <.05). No related additional local or systemic morbidity was registered in this series. There was a statistically significant positive relationship between increased diameter of vagal nerve and increased electromyography (EMG) amplitude (p =.03). There was also a significant increase of amplitude between initial and final vagal nerve stimulation in uneventful cases (p =.02). Conclusion We analyzed the technical issues to achieve improved vagal nerve critical view of safety dissection, stimulation, and C-IONM probe placement.

Continuous intraoperative neuromonitoring in thyroid surgery: Safety analysis of 400 consecutive electrode probe placements with standardized procedures / A. Mangano, H.Y. Kim, C.-. Wu, S. Rausei, S. Hui, L. Xiaoli, F.-. Chiang, D.H. Roukos, G.D. Lianos, E. Volpi, G. Dionigi. - In: HEAD & NECK. - ISSN 1043-3074. - 38:Suppl. 1(2016), pp. E1568-E1574. [10.1002/hed.24280]

Continuous intraoperative neuromonitoring in thyroid surgery: Safety analysis of 400 consecutive electrode probe placements with standardized procedures

G. Dionigi
2016

Abstract

Background Continuous intraoperative neuromonitoring (C-IONM) is a new technology and it is appropriate to analyze its safety. Methods C-IONM was performed according to a standardized technique to control any adverse events and electrode positioning issues. Results Four hundred vagal nerve dissections were analyzed considering vagal nerve diameter, mean time effort for C-IONM probe positioning, and electrode dislocation rate. A significant superior dislocation rate in case of: (a) when a 3 mm automatic periodic stimulating (APS) electrode size was used in a vagal nerve diameter <2 mm; (b) anterior access; and (c) vagal nerve A subtype in relation (p <.05). No related additional local or systemic morbidity was registered in this series. There was a statistically significant positive relationship between increased diameter of vagal nerve and increased electromyography (EMG) amplitude (p =.03). There was also a significant increase of amplitude between initial and final vagal nerve stimulation in uneventful cases (p =.02). Conclusion We analyzed the technical issues to achieve improved vagal nerve critical view of safety dissection, stimulation, and C-IONM probe placement.
continuous intraoperative neuromonitoring; guidelines; safety; standardized surgical technique; thyroid surgery
Settore MED/18 - Chirurgia Generale
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/881872
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