Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.
Department of Breast and Endocrine Surgery, Haukeland University Hospital, Bergen, Norway.
Laryngoscope. 2020 Apr;130(4):1090-1096. doi: 10.1002/lary.28215. Epub 2019 Aug 2.
Gradual impairment of nerve conduction is expected to be tightly associated with simultaneous gradual loss of vocal cord contractility, related to the fact that injured axons are connected to a defined number of muscle cells. In clinical studies, there is a time gap between observed adverse electromyographic (EMG) changes and examination of vocal cord function. This study evaluates the impact of intraoperative EMG changes on synchronous vocal cord contractility by simultaneous use of continuous intraoperative neuromonitoring (C-IONM) and accelerometry for registration of actual vocal cord function at a given change of EMG amplitude.
EMG was obtained following vagus nerve stimulation by use of C-IONM. A vocal cord accelerometer probe that could be attached to the vocal cords was developed based on a LIS3DH ultra low-power high performance three axis linear accelerometer (STMicroelectronics, Geneva, Switzerland). Accelerometer data were registered continuously together with EMG data during traction injury of the recurrent laryngeal nerve (RLN) until an amplitude depression ≤100 μV.
Six RLN from four immature domestic pigs were studied. Vocal cord contractility assessed by vocal cord accelerometry decreased in parallel with EMG amplitude, with significant correlations ranging from 0.707 to 0.968.
Decrease of EMG amplitude during traction injury to the RLN injury is closely associated with a parallel drop in vocal cord contractility.
NA Laryngoscope, 130:1090-1096, 2020.
神经传导的逐渐损伤预计与声带收缩力的同时逐渐丧失密切相关，这与受损轴突与一定数量的肌细胞相连的事实有关。在临床研究中，观察到的不良肌电图（EMG）变化与声带功能检查之间存在时间间隔。本研究通过同时使用连续术中神经监测（C-IONM）和加速度计来登记 EMG 幅度变化时声带实际功能的变化，评估术中 EMG 变化对声带同步收缩性的影响。
通过使用 C-IONM 进行迷走神经刺激获得 EMG。根据 LIS3DH 超低功耗高性能三轴线性加速度计（STMicroelectronics，日内瓦，瑞士）开发了一种可以附着在声带的声带加速度计探头。在 RLN 牵引损伤期间，连续记录加速度计数据和 EMG 数据，直到振幅降低≤100μV。
研究了来自四只未成年家猪的六根 RLN。通过声带加速度计评估的声带收缩力与 EMG 幅度平行下降，相关系数从 0.707 到 0.968。
RLN 损伤牵引时 EMG 幅度的降低与声带收缩力的平行下降密切相关。
无喉镜，130:1090-1096，2020。
