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- Title
Vocal cord paralysis predicted by neural monitoring electrophysiologic changes with recurrent laryngeal nerve compressive neuropraxic injury in a canine model.
- Authors
Puram, Sidharth V.; Chow, Harold; Wu, Che ‐ Wei; Heaton, James T.; Kamani, Dipti; Gorti, Gautham; Chiang, Feng Yu; Dionigi, Gianlorenzo; Barczyński, Marcin; Schneider, Rick; Dralle, Henning; Lorenz, Kerstin; Randolph, Gregory W.
- Abstract
Background Recurrent laryngeal nerve (RLN) injury is a known complication of thyroid/parathyroid surgery. Intraoperative nerve monitoring (IONM) has been used to gain more information regarding the functional status of the RLN intraoperatively; however, the electromyography (EMG) parameters of RLN after nontransection neuropraxic compressive injury remain unknown. Methods We developed a canine model to identify IONM EMG correlates of postoperative vocal cord paralysis (VCP) using a standardized method to simulate surgical RLN compression sufficient to cause VCP. Results Compression nerve injury decreased EMG amplitude and increased EMG latency, with a 60% increase in RLN threshold stimulation compared to preinjury values. If RLN amplitude decreases by 80% with an absolute amplitude of 300 μV or less in combination with a latency increase of 10% or more, then nerve injury and associated VCP is likely. Conclusion These results may help surgeons to prognosticate postoperative neural function and intraoperative decision-making regarding contralateral thyroid surgery. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1341-E1350, 2016
- Subjects
VOCAL cord injuries; LARYNGEAL nerve palsy; ELECTROPHYSIOLOGY; SURGICAL complications; THYROID gland surgery; PARATHYROID gland surgery
- Publication
Head & Neck, 2016, Vol 38, pE1341
- ISSN
1043-3074
- Publication type
Article
- DOI
10.1002/hed.24225