Vagal nerve stimulation without dissecting the carotid sheath during intraoperative neuromonitoring of the recurrent laryngeal nerve in thyroid surgery1. Issue 10 (18th September 2012)

• Record Type: Journal Article
• Authors: Wu, Che‐Wei; Dionigi, Gianlorenzo; Chen, Hui‐Chun; Chen, Hsiu‐Ya; Lee, Ka‐Wo; Lu, I‐Cheng; Chang, Pi‐Ying; Hsiao, Pi‐Jung; Ho, Kuen‐Yao; Chiang, Feng‐Yu
• Is Part Of: Head & neck. Volume 35:Issue 10(2013:Oct.)
• Page Start: 1443
• Page End: 1447
• Publication Date: 2012-09-18
• Subjects: Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.23154
• Languages: English
• ISSNs: 1043-3074

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="hed23154-sec-0001" sec-type="section"> <title>Background</title> <p>Vagal nerve stimulation (VNS) has been recommended as a routine procedure during intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN). However, many surgeons have been discouraged from performing VNS because of the need for opening the carotid sheath. The purpose of this study was to investigate the feasibility and reliability of VNS without carotid sheath dissection.</p> </sec> <sec id="hed23154-sec-0002" sec-type="section"> <title>Methods</title> <p>Two hundred twenty patients with 376 nerves at risk were enrolled in this study. VNS without nerve exposure during IONM was applied by simply pressing a ball‐tip stimulator on the space between the carotid artery and jugular vein.</p> </sec> <sec id="hed23154-sec-0003" sec-type="section"> <title>Results</title> <p>VNS without nerve exposure was feasible in all cases and did not result in any morbidity. All VNS signals were successfully obtained within 30 minutes of the start of the operation and all showed a clear and reliable laryngeal electromyography (EMG) response that was similar to that from the conventional method in which nerve exposure for VNS is applied.</p> </sec> <sec id="hed23154-sec-0004" sec-type="section"> <title>Conclusions</title> <p>VNS without dissecting the carotid sheath is feasible and reliable, rendering it a simple, safe, and surgeon‐friendly procedure during IONM. © 2012 Wiley Periodicals, Inc. <italic>Head Neck</italic> 35: 1443–1447, 2013</p> </sec> </abstract>