甲状腺切除术中外展神经术中神经监测的成功率和学习曲线。
Success rate and learning curve of intraoperative neural monitoring of the external branch of the superior laryngeal nerve in thyroidectomy.
机构信息
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea.
Department of Anesthesiology and Pain Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea.
出版信息
Head Neck. 2021 Dec;43(12):3946-3954. doi: 10.1002/hed.26895. Epub 2021 Oct 11.
BACKGROUND
This study aimed to evaluate the success rate and learning curve of intraoperative neural monitoring (IONM) of the external branch of the superior laryngeal nerve (EBSLN) in thyroidectomy.
METHODS
We studied 130 consecutive patients (200 nerves at risk [NARs]) who had undergone conventional thyroidectomy with IONM of the recurrent laryngeal nerve (RLN) and EBSLN from January 2017 to March 2020. The learning curve was defined as the number of NARs required to achieve an effective and reliable neuromonitoring rate.
RESULTS
IONM of the EBSLN was successful in 136/200 (68%) NARs. The cutoff point of the learning curve was 45 NARs (28 patients). The neural identification rate of EBSLN was significantly higher in the post-learning 155 NARs group than the pre-learning group (82.6% vs. 17.8%, p < 0.001).
CONCLUSIONS
Approximately 45 NAR neuromonitoring attempts were required to reach a significant increase in the EBSLN identification rate and overcome the learning curve.
背景
本研究旨在评估术中神经监测（IONM）在甲状腺切除术中对外展神经（EBSLN）的成功率和学习曲线。
方法
我们研究了 2017 年 1 月至 2020 年 3 月期间接受常规甲状腺切除术和喉返神经及 EBSLN 的 IONM 的 130 例连续患者（200 个风险神经）。学习曲线定义为达到有效和可靠的神经监测率所需的神经数量。
结果
EBSLN 的 IONM 在 136/200（68%）个 NAR 中成功。学习曲线的截止点为 45 个 NAR（28 例患者）。在学习后 155 个 NAR 组中，EBSLN 的神经识别率明显高于学习前组（82.6%比 17.8%，p<0.001）。
结论
大约需要 45 个 NAR 神经监测尝试才能显著提高 EBSLN 的识别率并克服学习曲线。
Zotero 插件