Initial experience with S-shaped electrode for continuous vagal nerve stimulation in thyroid surgery
Sam Van Slycke1, Jean-Pierre Gillardin, Nele Brusselaers
1Department of General and Endocrine Surgery, OLV Clinic Aalst, Moorselbaan 164, 9300, Aalst, Belgium. Sam.Van.Slycke@olvz-aalst.be
Langenbeck'S Archives of Surgery
|March 6, 2013
Summary
Continuous vagal nerve monitoring accurately predicts vocal cord palsy during thyroid surgery. This method, using an S-shaped electrode, helps surgeons avoid recurrent laryngeal nerve injury and potential vocal cord paralysis.
Area of Science:
- Otolaryngology
- Surgical Neurology
- Thyroid Surgery
Background:
- Recurrent laryngeal nerve (RLN) and vagal nerve (VN) monitoring are crucial in thyroid surgery to prevent vocal cord paralysis.
- Continuous neuromonitoring offers potential advantages over intermittent monitoring for avoiding nerve damage.
Purpose of the Study:
- To evaluate the clinical value of continuous vagal nerve neuromonitoring in predicting vocal cord injury during thyroidectomies.
Main Methods:
- A prospective, single-center study involving 100 consecutive thyroidectomies.
- Continuous vagal nerve stimulation was performed using an S-shaped electrode.
Main Results:
- Out of 180 nerves at risk, four cases (2.2%) experienced recurrent laryngeal nerve palsy, with one definitive case.
- Temporary palsies were associated with intra-operative amplitude diminution, while loss of signal occurred in all palsy cases.
Conclusions:
- Continuous vagal nerve neuromonitoring is accurate and precise for predicting vocal cord palsy.
- An atraumatic and stable vagal electrode is essential for effective monitoring.
- Amplitude changes appear to be significant warning signs for potential vocal cord injury.
