Intra-operative neuromonitoring of the vagus nerve during thyroidectomy. A prospective study.
Clin Otolaryngol
; 41(5): 454-60, 2016 Oct.
Article
em En
| MEDLINE
| ID: mdl-26407748
ABSTRACT
OBJECTIVES:
To determine whether intra-operative neuromonitoring (IONM) of the vagus nerve during thyroidectomy can predict postoperative vocal fold palsy.DESIGN:
A single-centre, prospective study.SETTING:
University Hospital.PARTICIPANTS:
A total of 95 patients underwent thyroid surgery. A total of 160 vagus nerves were studied. The amplitude of the action potential of vocal muscles was recorded intra-operatively by indirect supramaximal stimulation of the vagus nerve. All patients underwent flexible fibre-optic laryngoscopy on postoperative day 1 to detect the presence of vocal fold palsy. MAIN OUTCOMEMEASURES:
The primary outcome measure was the difference of the action potential amplitude of the vagus nerve before and after resection of the thyroid lobe. Statistical analysis determined the amplitude variation cut-off able to accurately predict postoperative vocal fold palsy.RESULTS:
Transient vocal fold palsy was observed in 4.375% of cases, and permanent fold palsy was observed in 1.25% of cases. A decrease of the action potential amplitude by more than 61% was statistically significantly associated with postoperative vocal fold palsy. A greater than 87% decrease of the amplitude of the action potential was correlated with permanent postoperative vocal fold palsy.CONCLUSION:
IONM of the vagus nerve during thyroidectomy may accurately predict postoperative vocal fold palsy.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Tireoidectomia
/
Nervo Vago
/
Paralisia das Pregas Vocais
/
Monitorização Intraoperatória
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Clin Otolaryngol
Assunto da revista:
OTORRINOLARINGOLOGIA
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
França