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Nerve Monitoring (nerve + monitoring)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Nerve monitoring in ENT surgery

CLINICAL OTOLARYNGOLOGY, Issue 6 2005
Khaled Badran
No abstract is available for this article. [source]

How we do it: Nerve monitoring in ENT surgery: current UK practice

CLINICAL OTOLARYNGOLOGY, Issue 2 2005
C. Hopkins
Keypoints ,,Nerve injury may complicate mastoid, thyroid, parotid or cervical lymph node surgery. Continuous intra-operative monitoring may help prevent such injury. ,,Nerve monitoring is used by 51% of UK consultant surgeons performing primary mastoid surgery, 90% undertaking parotid surgery, and 24% of surgeons performing routine thyroid surgery. ,,The efficacy of such monitoring in reducing nerve injury during these procedures has not been established. Unless such evidence emerges, a surgeon will not automatically be considered negligent if operating without monitoring. [source]

Intraoperative cranial nerve monitoring

MUSCLE AND NERVE, Issue 3 2004
C. Michel Harper MD
Abstract The purpose of intraoperative monitoring is to preserve function and prevent injury to the nervous system at a time when clinical examination is not possible. Cranial nerves are delicate structures and are susceptible to damage by mechanical trauma or ischemia during intracranial and extracranial surgery. A number of reliable electrodiagnostic techniques, including nerve conduction studies, electromyography, and the recording of evoked potentials have been adapted to the study of cranial nerve function during surgery. A growing body of evidence supports the utility of intraoperative monitoring of cranial nerve nerves during selected surgical procedures. Muscle Nerve 29: 339,351, 2004 [source]

Postoperative complications after extracapsular dissection of benign parotid lesions with particular reference to facial nerve function

THE LARYNGOSCOPE, Issue 3 2010
Nils Klintworth MD
Abstract Objectives/Hypothesis: The desirable extent of surgical intervention for benign parotid tumors remains a matter of controversy. Superficial or total parotidectomy as a standard procedure is often said to be the gold standard; however, with it the risk of intraoperative damage to the facial nerve cannot be ignored. For some time now, extracapsular dissection without exposure of the main trunk of the facial nerve has been favored as an alternative for the treatment of discrete parotid tumors. Data on the incidence of facial nerve lesions and other acute postoperative complications of extracapsular dissection have been lacking until now. Study Design: Retrospective analysis. Methods: We performed a retrospective analysis of the data from patients in whom extracapsular dissection of a benign parotid tumor had been performed under facial nerve monitoring and as a primary intervention in our department between 2000 and 2008. Results: A total of 934 patients were operated on for a newly diagnosed benign tumor of the parotid gland. Three hundred seventy-seven patients (40%) underwent extracapsular dissection as a primary intervention. The most common postoperative complication was hypoesthesia of the cheek or the earlobe, as reported by 38 patients (10%). Eighteen patients (5%) developed a seroma and 13 patients (3%) a hematoma. A salivary fistula formed in eight patients (2%). Secondary bleeding occurred in three patients (0.8%). In 346 patients (92%) facial nerve function was normal (House-Brackmann grade I) in the immediate postoperative period, whereas 23 patients (6%) showed temporary facial nerve paresis (House-Brackmann grade II or III) and eight patients (2%) developed permanent facial nerve paresis (seven patients House-Brackmann grade II, one patient House-Brackmann grade III). Conclusions: Extracapsular dissection of benign parotid tumors is associated with a low rate of postoperative complications, a fact that is confirmed by the available literature. We therefore recommend that use of this technique always be considered as a means of treating benign parotid tumors as conservatively, that is, as uninvasively, as possible. Laryngoscope, 2010 [source]

Transcricothyroid electromyographic monitoring of the recurrent laryngeal nerve,,

THE LARYNGOSCOPE, Issue 10 2009
Eran E. Alon MD
Abstract Objectives/Hypothesis: To determine the usefulness of intraoperative nerve monitoring using an electrode placed in the midline through the cricothyroid membrane. Study Design: Retrospective records review. Methods: Patients of the otolaryngology department of our tertiary care academic medical center were identified if they had undergone either total thyroidectomy or total thyroid lobectomy accompanied by bilateral electromyographic (EMG) monitoring of the recurrent laryngeal nerve (RLN) between January 2007 and October 2007. Results: Forty-three patients were identified who had a total throidectomy or a total thyroid lobectomy. Nineteen of the 43 had intraoperative EMG monitoring of the RLN with placement of a single EMG electrode through the cricothyroid membrane; 11 had a thyroidectomy, and eight had a thyroid lobectomy. Overall, 30 at-risk nerves were stimulated with an EMG probe; 27 responded adequately and three (paralyzed before surgery) were unresponsive. Conclusions: Central placement of an EMG electrode through the cricothyroid membrane into the thyroarytenoid musculature is a safe and reliable technique for bilateral monitoring of the RLN that facilitates evaluation of postoperative function. Laryngoscope, 2009 [source]

NERVE STIMULATION IN THYROID SURGERY: IS IT REALLY USEFUL?

ANZ JOURNAL OF SURGERY, Issue 5 2007
Thorbjorn J Loch-Wilkinson
Background: Monitoring of the recurrent laryngeal nerve (RLN) has been claimed in some studies to reduce rates of nerve injury during thyroid surgery compared with anatomical dissection and visual identification of the RLN alone, whereas other studies have found no benefit. Continuous monitoring with endotracheal electrodes is expensive whereas discontinuous monitoring by laryngeal palpation with nerve stimulation is a simple and inexpensive technique. This study aimed to assess the value of nerve stimulation with laryngeal palpation as a means of identifying and assessing the function of the RLN and external branch of the superior laryngeal nerve (EBSLN) during thyroid surgery. Methods: This was a prospective case series comprising 50 consecutive patients undergoing total thyroidectomy providing 100 RLN and 100 EBSLN for examination. All patients underwent preoperative and postoperative vocal cord and voice assessment by an independent ear, nose and throat surgeon, laryngeal examination at extubation and all were asked to complete a postoperative dysphagia score sheet. Dysphagia scores in the study group were compared with a control group (n = 20) undergoing total thyroidectomy without nerve stimulation. Results: One hundred of 100 (100%) RLN were located without the use of the nerve stimulator. A negative twitch response occurred in seven (7%) RLN stimulated (two bilateral, three unilateral). Postoperative testing, however, only showed one true unilateral RLN palsy postoperatively (1%), which recovered in 7 weeks giving six false-positive and one true-positive results. Eighty-six of 100 (86%) EBSLN were located without the nerve stimulator. Thirteen of 100 (13%) EBSLN could not be identified and 1 of 100 (1%) was located with the use of the nerve stimulator. Fourteen per cent of EBSLN showed no cricothyroid twitch on EBSLN stimulation. Postoperative vocal function in these patients was normal. There were no instances of equipment malfunction. Dysphagia scores did not differ significantly between the study and control groups. Conclusion: Use of a nerve stimulator did not aid in anatomical dissection of the RLN and was useful in identifying only one EBSLN. Discontinuous nerve monitoring by stimulation during total thyroidectomy confers no obvious benefit for the experienced surgeon in nerve identification, functional testing or injury prevention. [source]