The Utility of Intraoperative Neuromonitoring in Pediatric Surgical Oncology.


Journal

Journal of pediatric surgery
ISSN: 1531-5037
Titre abrégé: J Pediatr Surg
Pays: United States
ID NLM: 0052631

Informations de publication

Date de publication:
Sep 2023
Historique:
received: 07 09 2022
revised: 28 01 2023
accepted: 04 02 2023
medline: 28 8 2023
pubmed: 13 3 2023
entrez: 12 3 2023
Statut: ppublish

Résumé

Intraoperative nerve monitoring (IONM) is a technique used to decrease the possibility of nerve-associated morbidity and damage to nearby neural structures during complex surgical procedures. The use and potential benefits of IONM in pediatric surgical oncology are not well-described. An overview of the current literature was performed to elucidate the various techniques that may be useful to pediatric surgeons for resection of solid tumors in children. The physiology and common types of IONM relevant to the pediatric surgeon are described. Important anesthetic considerations are reviewed. Specific applications for IONM that may be useful in pediatric surgical oncology are then summarized, including its use for monitoring the recurrent laryngeal nerve, the facial nerve, the brachial plexus, spinal nerves, and lower extremity nerves. Troubleshooting techniques regarding common pitfalls are then proposed. IONM is a technique that may be beneficial in pediatric surgical oncology to minimize nerve injury during extensive tumor resections. This review aimed to elucidate the various techniques available. IONM should be considered as an adjunct for the safe resection of solid tumors in children in the proper setting with the appropriate level of expertise. A multidisciplinary approach is advised. Additional studies are necessary to further clarify the optimal use and outcomes in this patient population. Level III.

Sections du résumé

BACKGROUND BACKGROUND
Intraoperative nerve monitoring (IONM) is a technique used to decrease the possibility of nerve-associated morbidity and damage to nearby neural structures during complex surgical procedures. The use and potential benefits of IONM in pediatric surgical oncology are not well-described.
METHODS METHODS
An overview of the current literature was performed to elucidate the various techniques that may be useful to pediatric surgeons for resection of solid tumors in children.
RESULTS RESULTS
The physiology and common types of IONM relevant to the pediatric surgeon are described. Important anesthetic considerations are reviewed. Specific applications for IONM that may be useful in pediatric surgical oncology are then summarized, including its use for monitoring the recurrent laryngeal nerve, the facial nerve, the brachial plexus, spinal nerves, and lower extremity nerves. Troubleshooting techniques regarding common pitfalls are then proposed.
CONCLUSION CONCLUSIONS
IONM is a technique that may be beneficial in pediatric surgical oncology to minimize nerve injury during extensive tumor resections. This review aimed to elucidate the various techniques available. IONM should be considered as an adjunct for the safe resection of solid tumors in children in the proper setting with the appropriate level of expertise. A multidisciplinary approach is advised. Additional studies are necessary to further clarify the optimal use and outcomes in this patient population.
LEVELS OF EVIDENCE METHODS
Level III.

Identifiants

pubmed: 36907768
pii: S0022-3468(23)00102-1
doi: 10.1016/j.jpedsurg.2023.02.003
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1708-1714

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Auteurs

Barrie S Rich (BS)

Division of Pediatric Surgery, Zucker School of Medicine at Hofstra/Northwell, Cohen Children's Medical Center, New Hyde Park, NY, USA. Electronic address: brich@northwell.edu.

Erin G Brown (EG)

Division of Pediatric Surgery, University of California, Davis Children's Hospital, Sacramento, CA, USA.

David H Rothstein (DH)

Division of Pediatric Surgery, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.

Reto M Baertschiger (RM)

Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.

G Adam Jackson (GA)

Division of Neurophysiology, BioTronic Neuro Network (BNN), St. Joseph's Hospital, Chicago, IL, USA.

Jonathan P Roach (JP)

Division of Pediatric Surgery, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA.

Bindi Naik-Mathuria (B)

Division of Pediatric Surgery, Baylor College of Medicine, Houston, TX, USA.

Elisabeth T Tracy (ET)

Division of Pediatric Surgery, Duke Children's Hospital and Health Center, Durham NC, USA.

Peter Mattei (P)

General, Thoracic and Fetal Surgery, Children's Hospital of Philadelphia, Philadelphia, Pa.

Richard D Glick (RD)

Division of Pediatric Surgery, Zucker School of Medicine at Hofstra/Northwell, Cohen Children's Medical Center, New Hyde Park, NY, USA.

Peter F Ehrlich (PF)

Section of Pediatric Surgery, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI, USA.

Jennifer H Aldrink (JH)

Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA.

David Rodeberg (D)

Division of Pediatric Surgery, Kentucky Children's Hospital, Lexington, KY, USA.

Timothy B Lautz (TB)

Division of Pediatric Surgery, Ann & Robert H Lurie Children's Hospital of Chicago, IL, USA.

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Classifications MeSH