Identifying a Safe Range of Stimulation Current for Intraoperative Neuromonitoring of the Recurrent Laryngeal Nerve: Results from a Canine Model.
- Author:
Tao LI
1
;
Gang ZHOU
1
;
Yang YANG
1
;
Zhi-Dong GAO
1
;
Peng GUO
1
;
Zhan-Long SHEN
1
;
Xiao-Dong YANG
1
;
Qi-Wei XIE
1
;
Ying-Jiang YE
1
;
Ke-Wei JIANG
1
;
Shan WANG
1
Author Information
- Publication Type:Journal Article
- MeSH: Animals; Dogs; Electromyography; Male; Monitoring, Intraoperative; methods; Recurrent Laryngeal Nerve; physiopathology; surgery; Thyroid Gland; physiopathology; surgery; Thyroidectomy; methods
- From: Chinese Medical Journal 2016;129(15):1830-1834
- CountryChina
- Language:English
-
Abstract:
BACKGROUNDIntraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) has been widely applied during thyroid surgery. However, the safe range of stimulation intensity for IONM remains undetermined.
METHODSTotal thyroidectomies were performed on twenty dogs, and their RLNs were stimulated with a current of 5-20 mA (step-wise in 5 mA increments) for 1 min. The evoked electromyography (EMG) of vocal muscles before and after supramaximal stimulation were recorded and compared. Acute microstructural morphological changes in the RLNs were observed immediately postoperatively under an electron microscope.
RESULTSThe average stimulating threshold for RLNs stimulated with 15 mA and 20 mA showed no significant changes compared to the unstimulated RLNs (15 mA group: 0.320 ± 0.123 mA vs. 0.315 ± 0.097 mA, P = 0.847; 20 mA group: 0.305 ± 0.101 mA vs. 0.300 ± 0.103 mA, P = 0.758). Similar outcomes were shown in average evoked EMG amplitude (15 mA group: 1,026 ± 268 μV vs. 1,021 ± 273 μV, P = 0.834; 20 mA group: 1,162 ± 275 μV vs. 1,200 ± 258 μV, P = 0.148). However, obvious acute microstructural morphological changes were observed in the nerves that were stimulated with 20 mA.
CONCLUSIONSA stimulation intensity less than 15 mA might be safe for IONM of the RLN.
