A new vagal anchor electrode for real-time monitoring of the recurrent laryngeal nerve

作者：Schneider Rick^*; Przybyl Joanna; Pliquett Uwe; Hermann Michael; Wehner Markus; Pietsch Uta Carolin; Koenig Fritjoff; Hauss Johann; Jonas Sven; Leinung Steffen

来源：American Journal of Surgery, 2010, 199(4): 507-514.

DOI：10.1016/j.amjsurg.2009.04.036

• Vagal nerve stimulation
• Vagal nerve electrode
• Anchor electrode
• Continuous neuromonitoring
• RLN monitoring
• Real-time monitoring
• Thyroid surgery
• RLN injury
• RLN paralysis

BACKGROUND: Despite conventional neuromonitoring, the recurrent laryngeal nerve (RLN) is still at risk for damage during thyroid surgery. The feasibility of continuous RLN monitoring by vagal nerve (VN) stimulation with a new anchor electrode should be shown, and electromyographic signal alterations of stressed RLN were analyzed to be alerted to imminent nerve failure whereby the nerve damage becomes reversible.
METHODS: VN stimulation was achieved in 23 pigs. Sensed signals were analyzed and stored as real-time audio/video feedback EMG system. RLN was stressed by mechanical and thermal injury: signal alterations were evaluated.
RESULTS: VNs were successfully real-time stimulated by using the anchor electrode. No complications or side effects during stimulation were detected. RLN injury led to an alteration of signal amplitude and latency period but signal restitution after injury.
CONCLUSIONS: Real-time monitoring of the RLN is technically feasible to perceive imminent nerve failure. The anchor electrode was safely and easy to handle. Its implementation is being tested in an ongoing clinical trial.

• 出版日期2010-4