Intraoperative assessment of recurrent laryngeal nerve function by monitoring EMG of lateral cricoaryteoid muscle
10.3760/cma.j.issn.1007-631X.2012.04.004
- VernacularTitle:环杓侧肌肌电图用于喉返神经功能的术中评估
- Author:
Gang ZHOU
;
Kewei JLANG
;
Yingjiang YE
;
Qiwei XLE
;
Jun QU
;
Xiaodong YANG
;
Kai SHEN
;
Peng GUO
;
Shan WANG
- Publication Type:Journal Article
- Keywords:
Thyroidectomy;
Recurrent laryngeal nerve;
Electromyography;
Lateral cricoarytenoid muscle;
Intraoperative nerve monitoring
- From:
Chinese Journal of General Surgery
2012;27(4):272-275
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the effectiveness and feasibility of intraoperaive recurrent laryngeal nerve(RLN) monitoring via lateral cricoarytenoid muscle(LCA) compound muscle action potential (CMAP) monitoring by bipolar electrode implanting. MethodsSeventy-four cases were evenly divided into nerve monitoring group and non-monitoring group,NIM-Response 2.0 was applied into monitoring group for intraoperative nerve monitoring.A bipolar electrode was inserted into LCA to record CMAP,stimulating electrode intermittently stimulated exposed or unexposed recurrent laryngeal nerve to monitor the RLN function during cervical operation under the block anaesthesia of cervical plexus. ResultsThere were no statistically significant differences (P ＞ 0.05 ) in postoperative hospitalization days (5.14 ± 1.44 days,5.05 ± 1.31 days),operation time ( 125.54 ±42.23 min,107.30 ± 39.36 min) between monitoring group and the control group.Thirty-two RLNs were mapped their anatomical course with the NIM-Response 2.0 assistance before exposure,and 25 RLNs were anatomically exposed.The stimulating threshold between unexposed RLN (2.23 ± 0.57 mA) and exposed RLN ( 0.44 ± 0.20 mA) were statistically different ( P ＜ 0.01 ),but the evoked EMG amplitude(307.98 ± 253.47 μV,234.36 ± 142.18 μV) were not statistically different (P ＞ 0.05 ).With the NIM-Response 2.0 assistance the course of the unexposed RLNs detected were consistent to the course of the RLNs when exposed completely.ConclusionsIt is a effective and feasible method to monitor the RLN function by recording the CMAP of lateral cricoarytenoid muscle(LCA) via bipolar electrode implanted into LCA under block anaesthesia of the cervical plexus.
