Pathak Soumi, Dubey Mamta, Yadav Vishal
Consultant Anaesthesiology, Rajiv Gandhi Cancer Institute & Research Centre (RGCIRC), Sector 5, Delhi, India.
Present Address: Consultant Anaesthesiology, Rajiv Gandhi Cancer Institute & Research Centre, Sector 5, Rohini, Delhi, 11085 India.
Indian J Otolaryngol Head Neck Surg. 2025 Jun;77(6):2421-2424. doi: 10.1007/s12070-025-05510-8. Epub 2025 May 2.
In this report, we describe the successful anaesthetic management and intermittent intraoperative nerve monitoring (IONM) of a patient with a retrosternal goitre that caused severe tracheal compression (more than 70% occlusion) and tested positive for Pemberton's sign. While endotracheal tubes (ETT) with vocal cord surface electrodes are commonly used for IONM, they cannot be used in cases of distal tracheal compression, specifically when the compression occurs 5 cm or more below the vocal cords. In such situations, these neuromonitoring ETTS can get displaced and lose contact with the vocal cords, ultimately undermining their effectiveness. Electrodes attached to the thyroid cartilage can be used to monitor V1-R1-R2-V2 signals in such cases.
在本报告中，我们描述了一例胸骨后甲状腺肿患者的成功麻醉管理及术中间歇性神经监测（IONM）情况。该患者气管严重受压（超过70%阻塞）且Pemberton征呈阳性。虽然带有声带表面电极的气管内导管（ETT）常用于IONM，但在气管远端受压的情况下，特别是当压迫发生在声带下方5厘米或更低位置时，不能使用此类导管。在这种情况下，这些神经监测ETT可能会移位并与声带失去接触，最终影响其有效性。在这种情况下，可使用附着于甲状软骨的电极来监测V1-R1-R2-V2信号。
