Role of the Laryngeal Adductor Reflex in the Prevention of Thermal Injury to the Recurrent Laryngeal Nerve in Thyroid Surgery: A Case Report.

IF 2.3 3区医学 Q1 OTORHINOLARYNGOLOGY Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2024-12-18 DOI:10.1002/hed.28038

M Ángeles Sánchez Roldán, Dulce Moncho, Mercedes Velasco, E Madalina Petriman, Héctor Duque, Ramón Vilallonga, Manuel Armengol, Óscar González

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Abstract

Background: Intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) aims to detect and prevent iatrogenic damage during thyroid surgery. Mechanisms of injury include traction, heat damage, and nerve transection. Continuous IONM (C-IONM) techniques detect impending damage due to traction and heat related when they are still reversible.

Methods: We present a 73-year-old woman who underwent a total thyroidectomy due to a goiter. The IONM included intermittent IONM (I-IONM) in combination with C-IONM using the laryngeal adductor reflex (LAR). The intraoperative neurophysiological signals recorded were correlated with the surgical maneuver and the postoperative evaluation.

Results: During surgery, a significant decrease in left LAR amplitude was observed, coinciding with the use of the harmonic. After some corrective maneuvers, the intraoperative signals recovered, and the postoperative examination showed adequate VF function.

Conclusions: C-IONM of the RLN using the LAR can be a valuable tool for detecting and preventing thermal spread injury during thyroid surgery.

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喉内收肌反射在预防甲状腺手术中喉返神经热损伤中的作用：1例报告。

背景：术中神经监测（IONM）喉返神经（RLN）的目的是发现和预防甲状腺手术中的医源性损伤。损伤机制包括牵引、热损伤和神经横断。连续离子离子探测技术（C-IONM）可以检测到由于牵引和热相关的潜在损伤，当它们仍然是可逆的。方法：我们提出一个73岁的妇女谁接受了全甲状腺切除术，由于甲状腺肿。IONM包括间歇性IONM （I-IONM）和使用喉内收肌反射（LAR）的C-IONM。术中记录的神经生理信号与手术操作及术后评价相关。结果：术中观察到左侧LAR幅度明显下降，与谐波的使用一致。经过一些矫正操作，术中信号恢复，术后检查显示VF功能正常。结论：在甲状腺手术中，使用LAR对RLN进行C-IONM检测和预防热扩散损伤是一种有价值的工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.