Kim Hoon Yub, Tufano Ralph P, Randolph Gregory, Barczyński Marcin, Wu Che-Wei, Chiang Feng-Yu, Liu Xiaoli, Masuoka Hiroo, Miyauchi Akira, Park Soo Young, Kwak Hee Yong, Lee Hye Yoon, Dionigi Gianlorenzo
Department of Surgery, KUMC Thyroid Center, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Division of Head and Neck Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Head Neck. 2016 Apr;38 Suppl 1:E1004-8. doi: 10.1002/hed.24145. Epub 2015 Jul 18.
The purpose of this study was to evaluate electromyography (EMG) amplitude and latency changes during tube dislocation in monitored thyroid surgery, which may be observed without recurrent laryngeal nerve injury.
Duroc-Landrace piglets were intubated with the TriVantage EMG tube. We measured EMG changes during both upward and downward tube dislocation (10-20 mm) and rotation (45-90°) with continuous neuromonitoring.
The EMG amplitude varied significantly with induced endotracheal tube rotation and depth changes. However, the EMG latency was relatively unaffected by such tube dislocation, just a transient artifactual latency change was observed in the situation of extreme amplitude variation.
Amplitude changes without latency changes may be due to changes in tube position alone during surgery, but could still reflect a neurophysiologic event; amplitude changes during neuropraxic injury merit additional investigation. Thus, the combined event (concordant amplitude decrease and latency increase) serves as an appropriate adverse EMG event correlating with impending neural injury. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1004-E1008, 2016.
本研究旨在评估在监测甲状腺手术中气管导管移位期间肌电图（EMG）的幅度和潜伏期变化，这些变化可能在无喉返神经损伤的情况下被观察到。
用TriVantage肌电图导管对杜洛克-长白猪仔进行插管。在持续神经监测下，我们测量了气管导管向上和向下移位（10 - 20毫米）以及旋转（45 - 90°）期间的肌电图变化。
肌电图幅度随气管导管的诱导旋转和深度变化而显著变化。然而，肌电图潜伏期相对不受此类导管移位的影响，仅在极端幅度变化的情况下观察到短暂的人为潜伏期变化。
幅度变化而潜伏期不变可能仅归因于手术期间导管位置的改变，但仍可能反映神经生理事件；神经失用性损伤期间的幅度变化值得进一步研究。因此，联合事件（幅度一致降低和潜伏期增加）是与即将发生的神经损伤相关的合适的不良肌电图事件。© 2015威利期刊公司。《头颈》38: E1004 - E1008, 2016。
