RESUMO
La cirugía laringotraqueal conlleva un riesgo inherente de lesión de los nervios laríngeos recurrentes (NLR). Estas complicaciones incluyen desde una disfonía menor hasta una parálisis bilateral de ambas cuerdas vocales. La neuromonitorización intraoperatoria de los NLR se desarrolló en el campo de la cirugía tiroidea con la finalidad de preservar la función de los nervios y de las cuerdas vocales. Sin embargo, la cirugía traqueal precisa una intubación intracampo de la tráquea distal, lo que limita el uso de la neuromonitorización mediante los tubos endotraqueales convencionales con electrodos de superficie. Expuesto este reto, presentamos un método alternativo para la neuromonitorización intraoperatoria de los NLR durante la cirugía laringotraqueal mediante la inserción de electrodos en la musculatura intralaríngea a través de una punción bilateral del cartílago tiroides (AU)
Laryngotracheal surgery has an inherent risk of injury to the recurrent laryngeal nerves (RLN). These complications go from minor dysphonia to even bilateral vocal cord paralysis. The intraoperative neuromonitoring of the RLN was developed in the field of thyroid surgery, in order to preserve nerve and vocal cord function. However, tracheal surgery requires in-field intubation of the distal trachea, which limits the use of nerve monitoring using conventional endotracheal tube with surface electrodes. Given these challenges, we present an alternative method for nerve monitoring during laryngotracheal surgery through the insertion of electrodes within the endolaryngeal musculature by bilateral puncture (AU)
Assuntos
Humanos , Feminino , Adulto , Monitorização Neurofisiológica Intraoperatória/métodos , Traumatismos do Nervo Laríngeo/prevenção & controle , Doenças da Glândula Tireoide/cirurgia , Estenose Traqueal/cirurgia , Laringe/cirurgia , Traqueia/cirurgia , Complicações Intraoperatórias , Estenose Traqueal/etiologiaRESUMO
Laryngotracheal surgery has an inherent risk of injury to the recurrent laryngeal nerves (RLN). These complications go from minor dysphonia to even bilateral vocal cord paralysis. The intraoperative neuromonitoring of the RLN was developed in the field of thyroid surgery, in order to preserve nerve and vocal cord function. However, tracheal surgery requires in-field intubation of the distal trachea, which limits the use of nerve monitoring using conventional endotracheal tube with surface electrodes. Given these challenges, we present an alternative method for nerve monitoring during laryngotracheal surgery through the insertion of electrodes within the endolaryngeal musculature by bilateral puncture.