! ORL via Alexandros G.Sfakianakis on Inoreader: Vocal cord paralysis predicted by neural monitoring electrophysiologic changes with recurrent laryngeal nerve compressive neuropraxic injury in a canine model

! ORL via Alexandros G.Sfakianakis on Inoreader

Vocal cord paralysis predicted by neural monitoring electrophysiologic changes with recurrent laryngeal nerve compressive neuropraxic injury in a canine model Sep 8th 2015, 16:19, by Sidharth V. Puram, Harold Chow, Che-Wei Wu, James T. Heaton, Dipti Kamani, Gautham Gorti, Feng Yu Chiang, Gianlorenzo Dionigi, Marcin Barczyński, Rick Schneider, Henning Dralle, Kerstin Lorenz, Gregory W. Randolph 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, 2015

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