Continuous intraoperative neuromonitoring of the recurrent laryngeal nerve during lung operations.
Continuous intraoperative neuromonitoring (cIONM)
double-lumen tube (DLT)
recurrent laryngeal nerve (RLN)
thoracotomy
Journal
Journal of thoracic disease
ISSN: 2072-1439
Titre abrégé: J Thorac Dis
Pays: China
ID NLM: 101533916
Informations de publication
Date de publication:
31 Aug 2023
31 Aug 2023
Historique:
received:
25
10
2022
accepted:
09
06
2023
medline:
11
9
2023
pubmed:
11
9
2023
entrez:
11
9
2023
Statut:
ppublish
Résumé
The recurrent laryngeal nerve (RLN), especially on the left side, is particularly vulnerable during lung operations. Therefore, continuous intraoperative neuromonitoring (cIONM) would be desirable. With the use of a double-lumen tube (DLT) for single-lung ventilation, there is some uncertainty where the recording electrode should be positioned. The aim of this study was to assess the feasibility of this technique and to predict the ideal position of a single recording electrode. Patients scheduled to undergo left thoracotomy due to pulmonary pathologies, two adhesive electrodes were affixed consecutively above the proximal cuff of the DLT prior to intubation for a precise location of the recording from the vocal cords. Following thoracotomy, the vagus nerve alongside the aortic arch was exposed. A continuous stimulation probe (Saxophone Strong signals with an amplitude of at least 165 µV were recorded in 18 of 20 patients. In these patients 100% of the signals were recorded via the distally located electrode. An additional signal was recorded via the proximal electrode in four patients. cIONM was found to be a safe and reproducible technique. The described technique enables the use of cIONM of the RLN throughout the entire course of the surgical procedure.
Sections du résumé
Background
UNASSIGNED
The recurrent laryngeal nerve (RLN), especially on the left side, is particularly vulnerable during lung operations. Therefore, continuous intraoperative neuromonitoring (cIONM) would be desirable. With the use of a double-lumen tube (DLT) for single-lung ventilation, there is some uncertainty where the recording electrode should be positioned. The aim of this study was to assess the feasibility of this technique and to predict the ideal position of a single recording electrode.
Methods
UNASSIGNED
Patients scheduled to undergo left thoracotomy due to pulmonary pathologies, two adhesive electrodes were affixed consecutively above the proximal cuff of the DLT prior to intubation for a precise location of the recording from the vocal cords. Following thoracotomy, the vagus nerve alongside the aortic arch was exposed. A continuous stimulation probe (Saxophone
Results
UNASSIGNED
Strong signals with an amplitude of at least 165 µV were recorded in 18 of 20 patients. In these patients 100% of the signals were recorded via the distally located electrode. An additional signal was recorded via the proximal electrode in four patients. cIONM was found to be a safe and reproducible technique.
Conclusions
UNASSIGNED
The described technique enables the use of cIONM of the RLN throughout the entire course of the surgical procedure.
Identifiants
pubmed: 37691667
doi: 10.21037/jtd-22-1515
pii: jtd-15-08-4198
pmc: PMC10482653
doi:
Types de publication
Journal Article
Langues
eng
Pagination
4198-4206Informations de copyright
2023 Journal of Thoracic Disease. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-22-1515/coif). The authors have no conflicts of interest to declare.
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