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
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.
Head Neck. 2016 Apr;38 Suppl 1:E1341-50. doi: 10.1002/hed.24225. Epub 2015 Sep 8.
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.
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.
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.
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.
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。
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。
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。
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。
