Recurrent laryngeal nerve injury with incomplete loss of electromyography signal during monitored thyroidectomy-evaluation and outcome
DC Field | Value | Language |
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dc.contributor.author | Wu, Che-Wei | - |
dc.contributor.author | Hao, Min | - |
dc.contributor.author | Tian, Mengzi | - |
dc.contributor.author | Dionigi, Gianlorenzo | - |
dc.contributor.author | Tufano, Ralph P. | - |
dc.contributor.author | Kim, Hoon Yub | - |
dc.contributor.author | Jung, Kwang Yoon | - |
dc.contributor.author | Liu, Xiaoli | - |
dc.contributor.author | Sun, Hui | - |
dc.contributor.author | Lu, I-Cheng | - |
dc.contributor.author | Chang, Pi-Ying | - |
dc.contributor.author | Chiang, Feng-Yu | - |
dc.date.accessioned | 2021-09-03T05:47:39Z | - |
dc.date.available | 2021-09-03T05:47:39Z | - |
dc.date.created | 2021-06-16 | - |
dc.date.issued | 2017-06 | - |
dc.identifier.issn | 1435-2443 | - |
dc.identifier.uri | https://scholar.korea.ac.kr/handle/2021.sw.korea/83367 | - |
dc.description.abstract | Purpose During monitored thyroidectomy, a partially or completely disrupted point of nerve conduction on the exposed recurrent laryngeal nerve (RLN) indicates true electrophysiologic nerve injury. Complete loss of signal (LOS; absolute threshold value < 100 mu V) at the end of operation often indicates a postoperative vocal cord (VC) palsy. However, the evaluation for the injured RLN with incomplete LOS and its functional outcome has not been well described. Methods Three hundred twenty-three patients with 522 RLNs at risk who underwent standardized monitored thyroidectomy were enrolled. The RLN was routinely stimulated at the most proximal (R-2p signal) and distal (R-2d signal) ends of exposure after thyroid resection to determine if there was an injured point on the RLN. Pre- and postoperative VC function was routinely examined. Results Twenty-nine RLNs (5.6 %) were detected with an injury point. Five nerves had complete LOS and other 24 nerves had incomplete LOS where the R-2p/R-2d reduction (% of amplitude reduction compared with proximal to distal RLN stimulation) ranged from 22 to 79 %. Postoperative temporary VC palsy was noted in those five RLNs with complete LOS (final vagal signal, V-2< 100 mu V) and four RLNs with incomplete LOS (R-2p/R-2d reduction 62-79 %; V-2 181-490 mu V). In the remaining 20 nerves with R-2p/R-2d reduction <= 53 % (V-2 373-1623 mu V), all showed normal VC mobility. Overall, false negative results were found in two RLNs (0.4 %) featuring unchanged V-2 and R-2p/R-2d but developed VC palsy. Conclusions Testing and comparing the R-2p/R-2d signal is a simple and useful procedure to evaluate RLN injury after its dissection and predict functional outcome. When the relative threshold value R-2p/R-2d reduction reaches over 60 %, surgeon should consider the possibility of postoperative VC palsy. | - |
dc.language | English | - |
dc.language.iso | en | - |
dc.publisher | SPRINGER | - |
dc.subject | INTRAOPERATIVE NEUROMONITORING IONM | - |
dc.subject | PORCINE MODEL | - |
dc.subject | PARATHYROID SURGERY | - |
dc.subject | ENDOTRACHEAL-TUBE | - |
dc.subject | STIMULATION | - |
dc.subject | IDENTIFICATION | - |
dc.subject | OPERATION | - |
dc.title | Recurrent laryngeal nerve injury with incomplete loss of electromyography signal during monitored thyroidectomy-evaluation and outcome | - |
dc.type | Article | - |
dc.contributor.affiliatedAuthor | Kim, Hoon Yub | - |
dc.identifier.doi | 10.1007/s00423-016-1381-8 | - |
dc.identifier.scopusid | 2-s2.0-84958763968 | - |
dc.identifier.wosid | 000401788500015 | - |
dc.identifier.bibliographicCitation | LANGENBECKS ARCHIVES OF SURGERY, v.402, no.4, pp.691 - 699 | - |
dc.relation.isPartOf | LANGENBECKS ARCHIVES OF SURGERY | - |
dc.citation.title | LANGENBECKS ARCHIVES OF SURGERY | - |
dc.citation.volume | 402 | - |
dc.citation.number | 4 | - |
dc.citation.startPage | 691 | - |
dc.citation.endPage | 699 | - |
dc.type.rims | ART | - |
dc.type.docType | Article | - |
dc.description.journalClass | 1 | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
dc.relation.journalResearchArea | Surgery | - |
dc.relation.journalWebOfScienceCategory | Surgery | - |
dc.subject.keywordPlus | INTRAOPERATIVE NEUROMONITORING IONM | - |
dc.subject.keywordPlus | PORCINE MODEL | - |
dc.subject.keywordPlus | PARATHYROID SURGERY | - |
dc.subject.keywordPlus | ENDOTRACHEAL-TUBE | - |
dc.subject.keywordPlus | STIMULATION | - |
dc.subject.keywordPlus | IDENTIFICATION | - |
dc.subject.keywordPlus | OPERATION | - |
dc.subject.keywordAuthor | Recurrent laryngeal nerve | - |
dc.subject.keywordAuthor | Intraoperative neuromonitoring | - |
dc.subject.keywordAuthor | Thyroid surgery | - |
dc.subject.keywordAuthor | Electromyography | - |
dc.subject.keywordAuthor | Loss of signal | - |
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