Division of Otolaryngology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA.
J Clin Neurophysiol. 2010 Feb;27(1):34-7. doi: 10.1097/WNP.0b013e3181cb42c5.
The objective of this study was to determine the normative values for threshold stimulation of the recurrent laryngeal nerve (RLN) using intraoperative neuromonitoring before and after thyroidectomy. Eighty patients with 111 at-risk nerves underwent thyroid surgery by a single surgical team at an academic medical center in central Pennsylvania during this retrospective study. RLN threshold measurements were taken before and after resection to determine the minimum current needed to stimulate the RLN. Risk of paresis was modeled using logistic regression, and risk was quantified using adjusted odds ratios. The results showed the average minimum current required for stimulation of the RLN before resection was 0.50 mA. The average RLN minimum threshold level after resection was 0.47 mA. The average difference in pre- and postresection RLN threshold current was -0.03 mA. The preresection RLN threshold level (P = 0.31), the postresection RLN threshold level (P = 0.82), and the difference in the pre- and postresection RLN threshold level (P = 0.16) all did not have a statistically significant effect on paresis. No other covariates had a significant association with paresis.
本研究旨在确定甲状腺切除术前后使用术中神经监测（IONM）对喉返神经（RLN）进行阈刺激的正常值。在这项回顾性研究中，宾夕法尼亚州中部的一家学术医疗中心的一个单一手术团队对 80 名患者的 111 条高危神经进行了甲状腺手术。在切除前和切除后进行 RLN 阈值测量，以确定刺激 RLN 所需的最小电流。使用逻辑回归对麻痹风险进行建模，并使用调整后的优势比来量化风险。结果显示，切除前刺激 RLN 所需的平均最小电流为 0.50 mA。切除后 RLN 的平均最小阈值水平为 0.47 mA。切除前后 RLN 阈值电流的平均差异为-0.03 mA。术前 RLN 阈值水平（P = 0.31）、术后 RLN 阈值水平（P = 0.82）以及切除前后 RLN 阈值水平的差异（P = 0.16）均对麻痹无统计学显著影响。其他协变量与麻痹无显著关联。
