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Recurrent laryngeal nerve monitoring with surface electrodes in pediatric thyroid surgery

Evan Jon Propst1, Jonah Gorodensky1, Jonathan Daniel Wasserman2

  • 1Department of Otolaryngology-Head & Neck Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

The Laryngoscope
|August 28, 2019
PubMed

Insights

Endotracheal tube (ETT) surface electrodes reliably monitor the recurrent laryngeal nerve (RLN) during pediatric thyroid surgery. Thyroid surgery temporarily reduces RLN function, influenced by tumor size and stimulation site.

Area of Science:

  • Pediatric Surgery
  • Otolaryngology
  • Nerve Monitoring

Background:

  • Recurrent laryngeal nerve (RLN) injury is a risk in pediatric thyroid surgery.
  • Accurate intraoperative monitoring is crucial for preserving RLN function in children.

Purpose of the Study:

  • To evaluate the reliability of endotracheal tube (ETT) surface electrodes for RLN monitoring in pediatric thyroid surgery.
  • To assess the effects of thyroid surgery on RLN function in pediatric patients.

Main Methods:

  • Prospective study of pediatric patients (<18 years) undergoing thyroidectomy.
  • Pre- and postoperative vocal cord mobility assessment.
  • Intraoperative RLN monitoring using ETT surface electrodes (adhesive or integrated).

Main Results:

  • ETT electrodes demonstrated reliable RLN monitoring.
  • Thyroid surgery led to decreased RLN stimulability (Nerveäna Power Index) and increased latency, related to tumor size.
  • Stimulation site influenced RLN evaluation, with no significant association with vocal cord mobility changes or voice issues.

Conclusions:

  • ETT surface electrodes are effective for intraoperative RLN monitoring in pediatric thyroid surgery.
  • Thyroid surgery temporarily impacts RLN function, with effects modulated by tumor size and stimulation location.
  • This monitoring method aids in preserving nerve function during pediatric thyroid procedures.
Abstract

Keywords:
Thyroidbiomarkerchildrenmonitorparesispediatricrecurrent laryngeal nervesurgerythyroidectomyvocal cord paralysis

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