在犬类模型中，通过神经监测电生理变化预测喉返神经压迫性神经失用损伤所致的声带麻痹。
Vocal cord paralysis predicted by neural monitoring electrophysiologic changes with recurrent laryngeal nerve compressive neuropraxic injury in a canine model.
作者信息
Puram Sidharth V, Chow Harold, Wu Che-Wei, Heaton James T, Kamani Dipti, Gorti Gautham, Chiang Feng Yu, Dionigi Gianlorenzo, Barczyński Marcin, Schneider Rick, Dralle Henning, Lorenz Kerstin, Randolph Gregory W
机构信息
Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Massachusetts.
Department of Otorhinolaryngology-Head and Neck Surgery, Kaohsiung Medical University Hospital, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
出版信息
Head Neck. 2016 Apr;38 Suppl 1:E1341-50. doi: 10.1002/hed.24225. Epub 2015 Sep 8.
BACKGROUND
Recurrent laryngeal nerve (RLN) injury is a known complication of thyroid/parathyroid surgery. Intraoperative nerve monitoring (IONM) has been used to gain more information regarding the functional status of the RLN intraoperatively; however, the electromyography (EMG) parameters of RLN after nontransection neuropraxic compressive injury remain unknown.
METHODS
We developed a canine model to identify IONM EMG correlates of postoperative vocal cord paralysis (VCP) using a standardized method to simulate surgical RLN compression sufficient to cause VCP.
RESULTS
Compression nerve injury decreased EMG amplitude and increased EMG latency, with a 60% increase in RLN threshold stimulation compared to preinjury values. If RLN amplitude decreases by 80% with an absolute amplitude of 300 μV or less in combination with a latency increase of 10% or more, then nerve injury and associated VCP is likely.
CONCLUSION
These results may help surgeons to prognosticate postoperative neural function and intraoperative decision-making regarding contralateral thyroid surgery. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1341-E1350, 2016.
背景
喉返神经（RLN）损伤是甲状腺/甲状旁腺手术已知的并发症。术中神经监测（IONM）已被用于在术中获取更多关于RLN功能状态的信息；然而，非横断性神经失用性压迫性损伤后RLN的肌电图（EMG）参数仍不清楚。
方法
我们建立了一个犬类模型，使用标准化方法模拟足以导致声带麻痹（VCP）的手术性RLN压迫，以确定IONM EMG与术后声带麻痹的相关性。
结果
压迫性神经损伤使EMG振幅降低，EMG潜伏期延长，与损伤前值相比，RLN阈值刺激增加了60%。如果RLN振幅降低80%，绝对振幅为300μV或更低，同时潜伏期增加10%或更多，则可能存在神经损伤及相关的VCP。
结论
这些结果可能有助于外科医生预测术后神经功能，并为对侧甲状腺手术的术中决策提供参考。©2015威利期刊公司。《头颈》38:E1341 - E1350，2016年。
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