Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy.
Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy.
Am J Surg. 2022 May;223(5):923-926. doi: 10.1016/j.amjsurg.2021.10.016. Epub 2021 Oct 15.
The aim of this study was to evaluate the effect of a single early administration of dexamethasone and escin after loss of signal (LOS) during a neuromonitored total thyroidectomy.
A retrospective analysis of results concerning consecutive patients undergoing total thyroidectomy was performed. Patients included in the study were divided into two groups: Group 1 for which a "wait and see" strategy was used; Group 2, receiving dexamethasone and escin immediately after LOS detection.
Overall 37 patients were included in Group 1 and 35 in Group 2. LOS recovery occurring in 29.7% of cases (n. 11) versus 65.7% (n. 23) respectively (p < 0.001). Postoperative fibrolayngoscopy for patients without LOS recovery showed normal cord function in 4 out of 26 cases (15.4%) in Group 1 and in 7 out of 12 (58.3%) in Group 2 (p < 0.001).
The early administration of dexamethasone and escin after LOS detection may achieve greater EMG signal recovery than a "wait and see" strategy.
本研究旨在评估在神经监测下甲状腺全切除术中出现信号丢失（LOS）后单次早期应用地塞米松和七叶皂苷钠对其的影响。
对连续接受甲状腺全切除术的患者的结果进行回顾性分析。研究中患者被分为两组：一组为“等待观察”策略（组 1）；另一组为 LOS 检测后立即使用地塞米松和七叶皂苷钠（组 2）。
共有 37 例患者被纳入组 1，35 例患者被纳入组 2。LOS 恢复分别发生在 29.7%（n=11）和 65.7%（n=23）的患者中（p<0.001）。对于 LOS 未恢复的患者，术后纤维喉镜检查显示，在组 1 的 26 例中有 4 例（15.4%）和组 2 的 12 例中有 7 例（58.3%）的声带功能正常（p<0.001）。
与“等待观察”策略相比，LOS 检测后早期应用地塞米松和七叶皂苷钠可能会获得更大的肌电图信号恢复。
