Eisele D W
Department of Otolaryngology--Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21203-6402, USA.
Laryngoscope. 1996 Apr;106(4):443-9. doi: 10.1097/00005537-199604000-00010.
Intraoperative electrophysiologic monitoring of the recurrent laryngeal nerve was performed with a commercially available device consisting of an endotracheal tube with integrated stainless-steel-wire surface EMG electrodes positioned at the level of the true vocal cords. Forty-two recurrent laryngeal nerves were successfully monitored with this system in 31 patients undergoing thyroidectomy or parathyroidectomy. In all cases, evoked EMG responses were elicited by direct electrical recurrent laryngeal nerve stimulation. Stimulus thresholds for evoked responses ranged from 0.2 to 0.6 mA (mean 0.3 mA) for the 37 nerves with preoperative ipsilateral normal vocal cord mobility. Mechanically evoked potentials with acoustic signals were also detected during the surgical procedures related to recurrent laryngeal nerve manipulation. It may be concluded that surface electrode monitoring of the recurrent laryngeal nerve with this system provides a simplified, noninvasive technique that is as sensitive as monitoring with intramuscular laryngeal electrodes.
使用一种市售设备对喉返神经进行术中电生理监测，该设备由一根气管内导管组成，导管上集成有位于真声带水平的不锈钢丝表面肌电图电极。在31例接受甲状腺切除术或甲状旁腺切除术的患者中，该系统成功监测了42条喉返神经。在所有病例中，通过直接电刺激喉返神经诱发肌电图反应。术前同侧声带活动正常的37条神经诱发反应的刺激阈值为0.2至0.6毫安（平均0.3毫安）。在与喉返神经操作相关的手术过程中，还检测到了有声信号诱发的机械电位。可以得出结论，该系统对喉返神经进行表面电极监测提供了一种简化的、非侵入性技术，其敏感性与使用喉内肌电极监测相同。
