Brauckhoff Michael, Gimm Oliver, Thanh Phuong Nguyen, Brauckhoff Katrin, Ukkat Jörg, Thomusch Oliver, Dralle Henning
Department of General, Visceral, and Vascular Surgery, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany.
J Pediatr Surg. 2002 Oct;37(10):1414-8. doi: 10.1053/jpsu.2002.35403.
Intraoperative neurostimulation of the recurrent laryngeal nerve may reduce nerve palsy during thyroid surgery and is well established in adults. No data regarding the value of neuromonitoring during thyroid surgery in children have been available.
In a retrospective study, the authors analyzed all children who underwent surgery in our department since 1995. Neurostimulation was performed as electromyography of the vocal muscle using an electrical stimulation electrode for identification of the recurrent nerve.
The authors performed thyroid resections in 97 children (mean, 11.1 years), 75 because of thyroid carcinoma. The recurrent nerve was identified in each patient. The neuromonitoring was used in 53 patients. Postoperatively, one temporary nerve palsy was identified in this group (1.89%). In the group of 44 nonstimulated patients, 2 temporary (4.55%) and one permanent nerve dysfunctions (2.27%) occurred. In all stimulated patients, the results of intraoperative neurostimulation were identical with the postoperative function of the vocal cords.
The intraoperative neurostimulation of the recurrent laryngeal nerve is a safe and reliable procedure in children and adolescents. It may reduce nerve damage during thyroid surgery. The neuromonitoring of the recurrent nerve is of high prediction for the postoperative function of the vocal cords.
术中对喉返神经进行神经刺激可减少甲状腺手术期间的神经麻痹，这在成人中已得到充分证实。关于儿童甲状腺手术中神经监测价值的数据尚无可用资料。
在一项回顾性研究中，作者分析了自1995年以来在本科室接受手术的所有儿童。神经刺激通过使用电刺激电极对声带肌肉进行肌电图检查来进行，以识别喉返神经。
作者对97名儿童（平均年龄11.1岁）进行了甲状腺切除术，其中75例是因为甲状腺癌。在每名患者中均识别出了喉返神经。53例患者使用了神经监测。术后，该组中发现1例暂时性神经麻痹（1.89%）。在44例未接受刺激的患者组中，发生了2例暂时性（4.55%）和1例永久性神经功能障碍（2.27%）。在所有接受刺激的患者中，术中神经刺激的结果与声带的术后功能一致。
术中对喉返神经进行神经刺激在儿童和青少年中是一种安全可靠的方法。它可能减少甲状腺手术期间的神经损伤。喉返神经的神经监测对声带的术后功能具有很高的预测价值。
