Department of Otorhinolaryngology-Head and Neck Surgery, International Thyroid Surgery Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Otorhinolaryngology-Head and Neck Surgery, Kaohsiung Municipal Siaogang Hospital, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Front Endocrinol (Lausanne). 2022 Jun 22;13:924731. doi: 10.3389/fendo.2022.924731. eCollection 2022.
Quantum molecular resonance (QMR) devices have been applied as energy-based devices in many head and neck surgeries; however, research on their use in thyroid surgery is lacking. This study aimed to investigate the safety parameters of QMR devices during thyroidectomy when dissection was adjacent to the recurrent laryngeal nerve (RLN).
This study included eight piglets with 16 RLNs, and real-time electromyography (EMG) signals were obtained from continuous intraoperative neuromonitoring (C-IONM). QMR bipolar scissor (BS) and monopolar unit (MU) were tested for safety parameters. In the activation study, QMR devices were activated at varying distances from the RLN. In the cooling study, QMR devices were cooled for varying time intervals, with or without muscle touch maneuver (MTM) before contacting with the RLN.
In the activation study, no adverse EMG change occurred when QMR BS and MU were activated at distances of 2 mm or longer from the RLNs. In the cooling study, no adverse EMG change occurred when QMR BS and MU were cooled in 2-second intervals or immediately after MTM.
QMR devices should be carefully used when performing RLN dissection during thyroid surgery. According to the activation and cooling safety parameters in this study, surgeons can avoid RLN injury by following standard procedures when using QMR devices.
量子分子共振（QMR）设备已作为能量设备应用于许多头颈部手术中，但在甲状腺手术中应用的研究较少。本研究旨在探讨在甲状腺手术中临近喉返神经（RLN）时 QMR 设备的安全参数。
本研究纳入了 8 头小猪的 16 条 RLN，通过连续术中神经监测（C-IONM）获得实时肌电图（EMG）信号。测试了 QMR 双极剪刀（BS）和单极装置（MU）的安全参数。在激活研究中，在 RLN 不同距离处激活 QMR 设备。在冷却研究中，在接触 RLN 之前，对 QMR 设备进行不同时间间隔的冷却，包括或不包括肌肉触摸操作（MTM）。
在激活研究中，当 QMR BS 和 MU 激活距离 RLN 2mm 或更长时，未发生不良 EMG 变化。在冷却研究中，当 QMR BS 和 MU 在 2 秒间隔内冷却或在 MTM 后立即冷却时，未发生不良 EMG 变化。
在甲状腺手术中进行 RLN 解剖时，应谨慎使用 QMR 设备。根据本研究中的激活和冷却安全参数，外科医生可以通过遵循标准程序来避免 RLN 损伤。
