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术内神经监测对预测甲状腺手术中的声带的影响

Başak Yalçıner¹, Ömer Bayır², Muhammed Kızılgül³

¹Department of Otolaryngology and Head and Neck Surgery, Ankara Bilkent City Hospital, Ankara, Turkey.

International archives of otorhinolaryngology

|March 13, 2026

概括

术内神经监测 (IONM) 可以预测甲状腺切除术后的复发性喉神经 (RLN) . 调整IONM值可以改善RLN的预测,有助于风险评估.

科学领域:

耳鼻喉科耳鼻喉科耳鼻喉科
手术瘤学手术瘤学
神经学神经学

背景情况:

回复性喉神经 (RLN) 是甲状腺切除术后的一个显著并发症.
在甲状腺手术期间探索各种方法来预防RLN.

研究的目的:

确定手术内神经监测 (IONM) 对手术后RLN的预测价值.
确定甲状腺切除术后导致RLN的因素.

主要方法:

在2014年1月至2020年12月期间,对287名接受甲状腺切除术的患者进行了回顾性分析.
评估患者的人口统计,手术细节和IONM结果,包括喉神经反应.
接收器操作特征 (ROC) 分析以确定最佳的IONM值.

主要成果:

在523个评估的神经中观察到4.2%的RLN.
整体甲状腺切除术,左侧RLN参与和恶性瘤与风险增加有关.
较低的平均第一和第二神经反应与相关;灵敏度在155μV和170μV的值下得到改善.

结论:

IONM电压变化和大小可以预测RLN.
使用更高的IONM值 (例如,>100μV) 可以提高预测RLN的灵敏度.
这些发现支持开发基于RLN的IONM风险分层系统.

关键词:

在手术内进行神经生理学监测.术后并发症术后并发症经常发生的喉神经损伤.甲状腺切除术甲状腺切除术声带麻声带麻

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