Abstract
Intraoperative neurophysiological monitoring (IOM) is used during surgeries of the head and neck, procedures to remove tumors of the thyroid, parathyroid, and parotid glands that put cranial nerves at risk, specifically the recurrent laryngeal nerve (RLN) (branch of CNX) and the facial nerve (Dionigi et al. Surg Technol Int 19:25–37, 2010). Monitoring and testing of the cranial nerves at risk accomplishes three goals: (1) to identify the nerve within the surgical field for the purposes of aiding the surgeon in avoiding damage to the nerve during the procedure, (2) to monitor the nerve during the course of the procedure in order to provide real-time feedback to the surgeon about the activity of the nerve, and (3) to provide the surgeon with a prognostic indicator of postoperative nerve function by assessing the stimulation threshold of the nerve at the end of the procedure (Randolph et al. Laryngoscope 121 Suppl 1:S1–16, 2011). These three goals of IOM for ENT procedures contribute to the overall mission of IOM to reduce the incidence of iatrogenic neurological injury. This chapter discusses practical applications of intraoperative monitoring for thyroidectomy, parathyroidectomy, and parotidectomy.
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Dionigi G, Bacuzzi A, Boni L, Rovera F, Rausei S, Frattini F, et al. The technique of intraoperative neuromonitoring in thyroid surgery. Surg Technol Int. 2010;19:25–37.
Randolph GW, Dralle H, International Intraoperative Monitoring Study G, Abdullah H, Barczynski M, Bellantone R, et al. Electrophysiologic recurrent laryngeal nerve monitoring during thyroid and parathyroid surgery: international standards guideline statement. Laryngoscope. 2011;121(Suppl 1):S1–16.
Julien N, Mosnier I, Bozorg Grayeli A, Nys P, Ferrary E, Sterkers O. Intraoperative laryngeal nerve monitoring during thyroidectomy and parathyroidectomy: a prospective study. Eur Ann Otorhinolaryngol Head Neck Dis. 2012;129(2):69–76.
Donnellan KA, Pitman KT, Cannon CR, Replogle WH, Simmons JD. Intraoperative laryngeal nerve monitoring during thyroidectomy. Arch Otolaryngol Head Neck Surg. 2009;135(12):1196–8.
Dralle H, Sekulla C, Lorenz K, Brauckhoff M, Machens A. Intraoperative monitoring of the recurrent laryngeal nerve in thyroid surgery. World J Surg. 2008;32(7):1358–66.
Apfelbaum RI, Kriskovich MD, Haller JR. On the incidence, cause, and prevention of recurrent laryngeal nerve palsies during anterior cervical spine surgery. Spine (Phila Pa 1976). 2000;25(22):2906–12.
Bailleux S, Bozec A, Castillo L, Santini J. Thyroid surgery and recurrent laryngeal nerve monitoring. J Laryngol Otol. 2006;120(7):566–9.
Dimopoulos VG, Chung I, Lee GP, Johnston KW, Kapsalakis IZ, Smisson HF 3rd, et al. Quantitative estimation of the recurrent laryngeal nerve irritation by employing spontaneous intraoperative electromyographic monitoring during anterior cervical discectomy and fusion. J Spinal Disord Tech. 2009;22(1):1–7.
Sanabria A, Silver CE, Suarez C, Shaha A, Khafif A, Owen RP, et al. Neuromonitoring of the laryngeal nerves in thyroid surgery: a critical appraisal of the literature. Eur Arch Otorhinolaryngol. 2013;270(9):2383–95.
Marchese-Ragona R, Restivo DA, Mylonakis I, Ottaviano G, Martini A, Sataloff RT, et al. The superior laryngeal nerve injury of a famous soprano. Amelita Galli-Curci. Acta Otorhinolaryngol Ital. 2013;33(1):67–71. PubMed PMID: 23620644, Pubmed Central PMCID: 3631811.
Kanotra SP, Kuriloff DB, Lesser J, Rest-Flarer F. GlideScope-assisted nerve integrity monitoring tube placement for intra-operative recurrent laryngeal nerve monitoring. J Laryngol Otol. 2012;126(12):1271–3.
Tsai CJ, Tseng KY, Wang FY, Lu IC, Wang HM, Wu CW, et al. Electromyographic endotracheal tube placement during thyroid surgery in neuromonitoring of recurrent laryngeal nerve. Kaohsiung J Med Sci. 2011;27(3):96–101.
Marcus B, Edwards B, Yoo S, Byrne A, Gupta A, Kandrevas J, et al. Recurrent laryngeal nerve monitoring in thyroid and parathyroid surgery: the University of Michigan experience. Laryngoscope. 2003;113(2):356–61.
Otto RA, Cochran CS. Sensitivity and specificity of intraoperative recurrent laryngeal nerve stimulation in predicting postoperative nerve paralysis. Ann Otol Rhinol Laryngol. 2002;111(11):1005–7.
Brennan J, Moore EJ, Shuler KJ. Prospective analysis of the efficacy of continuous intraoperative nerve monitoring during thyroidectomy, parathyroidectomy, and parotidectomy. Otolaryngol Head Neck Surg. 2001;124(5):537–43.
Eisele DW, Wang SJ, Orloff LA. Electrophysiologic facial nerve monitoring during parotidectomy. Head Neck. 2010;32(3):399–405.
Doikov IY, Konsulov SS, Dimov RS, Deenitchin GP, Yovchev IP. Stimulation electromyography as a method of intraoperative localization and identification of the facial nerve during parotidectomy: review of 15 consecutive parotid surgeries. Folia Med (Plovdiv). 2001;43(4):23–6.
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Birkholz, D.A., Davis, S.F. (2020). Monitoring ENT Procedures. In: Davis, S., Kaye, A. (eds) Principles of Neurophysiological Assessment, Mapping, and Monitoring. Springer, Cham. https://doi.org/10.1007/978-3-030-22400-4_16
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DOI: https://doi.org/10.1007/978-3-030-22400-4_16
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