Recurrent Laryngeal Nerve Monitoring During Thyroidectomy and Related Cervical Procedures in the Pediatric Population

White, W. Matthew; Randolph, Gregory W.; Hartnick, Christopher J.; Cunningham, Michael J.

doi:10.1001/archoto.2008.520

Cited by 56 publications

(54 citation statements)

References 24 publications

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“…Intraoperative monitoring of the recurrent laryngeal nerve has been proven to be useful in pediatric cervical surgeries. 23 However, there are currently no intraoperative NIM (nerve integrity monitor) electromyography endotracheal tubes small enough for CTS surgery in neonates, as the smallest NIM electromyography endotracheal tubes are currently sized at 5.0 (outer diameter 6.5 mm). Another type of monitoring device was the “Contact EMG” endotracheal tubes which had taped on or wrapped around the electrodes on the outside of the endotracheal tubes.…”

Section: Discussionmentioning

confidence: 99%

Vocal Cord Paralysis and Dysphagia after Aortic Arch Reconstruction and Norwood Procedure

Pham

Connelly²,

Wei

et al. 2014

Otolaryngol.--head neck surg.

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Objectives Determine the incidence of vocal cord paralysis and dysphagia after aortic arch reconstruction including Norwood procedure. Setting Tertiary Children’s Hospital Study Design Retrospective cohort. Methods Database/chart review of neonates requiring Norwood or arch surgery between January 2005 through December 2012. Demographics, postoperative vocal cord function, dysphagia, need for gastrostomy tube and/or tracheotomy, and long-term follow-up were reviewed. Results One hundred fifty-one consecutive subjects(96 Norwood, 55 aortic arch) were reviewed. Median age at repair was 9 days(IQR 7–13) for Norwood, 24 days(IQR 12–49) for arch reconstruction(p<0.001). Documentation of VC motion abnormality was found in 60/104(57.6%) subjects, and unavailable in 47:16 without documentation and 31 who expired prior to extubation. There were no significant differences in proportions of documented VC motion(p=0.337), dysphagia(p=0.987), and VC paralysis(p=0.706) between the arch and Norwood groups. Dysphagia was found in 73.5% of Norwood and 69.2% of arch subjects who had documented VC paralysis. Even without UVCP, dysphagia was present (56% Norwood,61% arch). Overall, 120/151(79.5%) required feeding evaluation and modified feeding regimen. Gastrostomy was required in 31% of Norwood and 23.6% of arch reconstruction overall. To date, mortality in this series is 55/151(36.4%) patients. Of those with VC paralysis, only 23(22%) had any otolaryngology follow-up after discharge from surgery. Over 75% with VC paralysis with follow-up after hospital discharge had persistent VC paralysis 11.5 months after diagnosis. Conclusion There is high incidence of UVCP and dysphagia after Norwood and arch reconstruction. Dysphagia was highly prevalent in both groups even without UVCP. Preoperative discussion on vocal cord function and dysphagia should be considered.

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Section: Discussionmentioning

confidence: 99%

Vocal Cord Paralysis and Dysphagia after Aortic Arch Reconstruction and Norwood Procedure

Pham

Connelly²,

Wei

et al. 2014

Otolaryngol.--head neck surg.

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“…Several methods can be used to prevent and detect a recurrent laryngeal injury early [13]. Visual identification of the recurrent laryngeal nerve during thyroid surgery by the surgeon is recommended.…”

Section: Discussionmentioning

confidence: 99%

“…As a risk minimization tool, intraoperative nerve monitoring (IONM) has been introduced to confirm recurrent laryngeal nerve function integrity intraoperatively [13]. A Xomed NIM II monitor (Medtronic Xomed, Jacksonville, Florida, USA) and Xomed NIM monitoring endotracheal tube with a surface EMG electrode was designed to rest on the luminal aspect of the bilateral true vocal cords.…”

Section: Discussionmentioning

confidence: 99%

Acute pulmonary edema secondary to upper airway obstruction by bilateral vocal cord paralysis after total thyroidectomy -A case report-

Ryu

2012

Korean J Anesthesiol

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This paper reports the case of a 65-year-old woman with a history of mild arterial hypertension who presented with acute pulmonary edema immediately after a total thyroidectomy. The edema was found to have been caused by an acute upper airway obstruction secondary to bilateral vocal cord paralysis. Her pulmonary edema resolved with treatment including reintubation, mechanical ventilation with positive end-expiratory pressure, diuretics, morphine, and fluid restriction. This report discusses the possible pathogenesis of this rare clinical situation. This case highlights the possibility of an acute upper airway obstruction caused by bilateral vocal cord paralysis after a total thyroidectomy and the need for prompt treatment to prevent the development of pulmonary edema.

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“…По данным литературы, стимуляция ВГН или блуждающего нерва не вызывает их по-вреждения и безопасна при использовании у детей и взрослых [31]. Более того, стимуля-ция блуждающего нерва не вызывает бради-аритмию или бронхоспазм [32].…”

Section: Introductionunclassified

Intraoperative neuromonitoring in thyroid and parathyroid surgery: indications and method

et al. 2016

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Recurrent Laryngeal Nerve Monitoring During Thyroidectomy and Related Cervical Procedures in the Pediatric Population

Cited by 56 publications

References 24 publications

Vocal Cord Paralysis and Dysphagia after Aortic Arch Reconstruction and Norwood Procedure

Vocal Cord Paralysis and Dysphagia after Aortic Arch Reconstruction and Norwood Procedure

Acute pulmonary edema secondary to upper airway obstruction by bilateral vocal cord paralysis after total thyroidectomy -A case report-

Intraoperative neuromonitoring in thyroid and parathyroid surgery: indications and method

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