Translational Study on Recurrent Laryngeal Nerve Temperature Susceptibility

Area of Science:

• Surgical Complications
• Nerve Injury
• Temperature Thresholds

Background:

• Recurrent laryngeal nerve (RLN) injury is a significant complication of thyroid surgery.
• Understanding the temperature thresholds causing RLN injury is crucial for patient safety.

Purpose of the Study:

• To investigate the temperature thresholds that lead to recurrent laryngeal nerve (RLN) injury during thyroid surgery.
• To establish safe temperature ranges for intraoperative neuromonitoring.

Main Methods:

• Utilized swine models with continuous intraoperative neuromonitoring.
• Applied varying water temperatures (1.9°C to 87.4°C) to the operative field.
• Defined threshold temperatures based on electromyography (EMG) signal changes.

Main Results:

• Low threshold temperature for RLN injury was 2.5°C, with recoverable EMG signals.
• High threshold temperature for RLN injury was 81.5°C, resulting in permanent signal loss.
• No adverse events were observed between 5.9°C and 77.5°C.

Conclusions:

• The recurrent laryngeal nerve (RLN) demonstrates resistance to cold injury.
• Temperatures exceeding 81.5°C pose a risk of permanent thermal injury to the RLN.
• Controlling surrounding temperatures within a safe range is vital during thyroid surgery to prevent RLN injury.