Electrophysiologic recurrent laryngeal nerve monitoring during thyroid and parathyroid surgery: International standards guideline statement

Laryngoscope

Volumn 121, Issue SUPPL. 1, 2011, Pages

  Randolph, Gregory W ^a,b   Dralle, Henning ^c,d  

^a HARVARD MEDICAL SCHOOL   (United States)

^b MASSACHUSETTS GENERAL HOSPITAL   (United States)

^c Department of Surgery ^*  (United States)

^d MARTIN LUTHER UNIVERSITY HALLE WITTENBERG   (Germany)

Author keywords

amplitude; anesthesia and nerve monitoring; electromyography characteristics; guidelines for intraoperative neural monitoring; international standards; intraoperative neural monitoring; laryngeal twitch; latency; loss of signal; nerve identification; nerve injury; nerve monitoring; nerve monitoring equipment; neural mapping; parathyroid surgery; Recurrent laryngeal nerve; superior laryngeal nerve; thyroid surgery; vagus nerve; vocal cord mobility

Indexed keywords

ATRACURIUM; DESFLURANE; FENTANYL; ISOFLURANE; MUSCLE RELAXANT AGENT; NEUROMUSCULAR BLOCKING AGENT; NITROUS OXIDE; OPIATE; PROPOFOL; REMIFENTANIL; ROCURONIUM; SUFENTANIL; SUXAMETHONIUM;

ALGORITHM; AMPLITUDE MODULATION; ANESTHESIA; ARTICLE; CLINICAL ASSESSMENT; CLINICAL PRACTICE; CRICOID; ELECTRODE; ELECTROMYOGRAM; ELECTROPHYSIOLOGY; ENDOCRINE SURGERY; ENDOTRACHEAL TUBE; EQUIPMENT; FALSE NEGATIVE RESULT; GLOTTIS; GOLD STANDARD; HUMAN; INTRAOPERATIVE PERIOD; LARYNGOSCOPY; LATENT PERIOD; NERVE; NERVE INJURY; NERVE LESION; NERVE STIMULATION; PARALYSIS; PARATHYROID GLAND; PATIENT MONITORING; PATIENT POSITIONING; POSTOPERATIVE PERIOD; PRACTICE GUIDELINE; PREOPERATIVE PERIOD; PRIORITY JOURNAL; PROBLEM SOLVING; PROFESSIONAL PRACTICE; PROFESSIONAL STANDARD; PROGNOSIS; RECURRENT LARYNGEAL NERVE; THYROID SURGERY; VAGUS NERVE; VAGUS NERVE STIMULATION; VOCAL CORD; VOCAL CORD PARALYSIS; ELECTROMYOGRAPHY; FEMALE; INJURY; INSTRUMENTATION; INTERNATIONAL COOPERATION; MALE; METHODOLOGY; PARATHYROIDECTOMY; PEROPERATIVE COMPLICATION; POSTOPERATIVE COMPLICATION; PREOPERATIVE CARE; REVIEW; RISK ASSESSMENT; STANDARD; THYROIDECTOMY; TREATMENT OUTCOME;

ELECTROMYOGRAPHY; FEMALE; GUIDELINE ADHERENCE; HUMANS; INTERNATIONALITY; INTRAOPERATIVE COMPLICATIONS; LARYNGOSCOPY; MALE; MONITORING, INTRAOPERATIVE; PARATHYROIDECTOMY; POSTOPERATIVE COMPLICATIONS; PRACTICE GUIDELINES AS TOPIC; PREOPERATIVE CARE; RECURRENT LARYNGEAL NERVE; REFERENCE STANDARDS; RISK ASSESSMENT; THYROIDECTOMY; TREATMENT OUTCOME; VOCAL CORD PARALYSIS;

EID: 78650805476     PISSN: 0023852X     EISSN: None     Source Type: Journal    
DOI: 10.1002/lary.21119     Document Type: Article

References (70)

1. Horne SK, Gal TJ, Brennan JA., Prevalence and patterns of intraoperative nerve monitoring for thyroidectomy. Otolaryngol Head Neck Surg 2007; 136: 952 - 956.
2. Sturgeon C, Sturgeon T, Angelos P., Neuromonitoring in thyroid surgery: attitudes, usage patterns, and predictors of use among endocrine surgeons. World J Surg 2009; 33: 417 - 425.
3. Eltzschig HK, Posner M, Moore FD Jr,. The use of readily available equipment in a simple method for intraoperative monitoring of recurrent laryngeal nerve function during thyroid surgery: initial experience with more than 300 cases. Arch Surg 2002; 137: 452 - 456; discussion 456-457.
4. Gavilan J, Gavilan C., Recurrent laryngeal nerve: identification during thyroid and parathyroid surgery. Arch Otolaryngol Head Neck Surg 1986; 112: 1286 - 1288.
5. Echeverri A, Flexon PB., Electrophysiologic nerve stimulation for identifying the recurrent laryngeal nerve in thyroid surgery: review of 70 consecutive thyroid surgeries. Am Surg 1998; 64: 328 - 333.
6. Tomoda C, Hirokawa Y, Uruno T, et al. Sensitivity and specificity of intraoperative recurrent laryngeal nerve stimulation test for predicting vocal cord palsy after thyroid surgery. World J Surg 2006; 30: 1230 - 1233.
7. Hamelmann WH, Meyer T, Timm S, Timmermann W., A critical estimation of intraoperative neuromonitoring (IONM) in thyroid surgery. Zentralbl Chir 2002; 127: 409 - 413.
8. Kunath M, Marusch F, Horschig P, Gastinger I., The value of intraoperative neuromonitoring in thyroid surgery: a prospective observational study with 926 patients. Zentralbl Chir 2003; 128: 187 - 190.
9. Jonas J, Bahr R., Intraoperative neuromonitoring of the recurrent laryngeal nerve: results and learning curve. Zentralbl Chir 2006; 131: 443 - 448.
10. Hemmerling TM, Schmidt J, Bosert C, Jacobi KE, Klein P., Intraoperative monitoring of the recurrent laryngeal nerve in 151 consecutive patients undergoing thyroid surgery. Anesth Analg 2001; 93: 396 - 399.
11. Dackiw AP, Rotstein LE, Clark OH., Computer- assisted evoked electromyography with stimulating surgical instruments for recurrent/external laryngeal nerve identification and preservation in thyroid and parathyroid operation. Surgery 2002; 132: 1100 - 1106; discussion 1107-1108.
12. Snyder S, Hendricks J., Introperative neurophysiology testing of the RLN: plaudits and pitfalls. Surgery 2005; 138: 1183 - 1192.
13. Brauckhoff M, Walls G, Brauckhoff K, Thanh PN, Thomusch O, Dralle H., Identification of the non- recurrent inferior laryngeal nerve using intraoperative neurostimulation. Langenbecks Arch Surg 2002; 386: 482 - 487.
14. Yarbrough DE, Thompson GB, Kasperbauer JL, Harper CM, Grant CS., Intraoperative electromyographic monitoring of the recurrent laryngeal nerve in reoperative thyroid and parathyroid surgery. Surgery 2004; 136: 1107 - 1115.
15. Robertson ML, Steward DL, Gluckman JL, Welge J,. Continuous laryngeal nerve integrity monitoring during thyroidectomy: does it reduce risk of injury? Otolaryngol Head Neck Surg 2004; 131: 596 - 600.
16. Dralle H, Sekulla C, Haerting J, et al. Risk factors of paralysis and functional outcome after recurrent laryngeal nerve monitoring in thyroid surgery. Surgery 2004; 136: 1310 - 1322.
17. Chan WF, Lang BH, Lo CY., The role of intraoperative neuromonitoring of recurrent laryngeal nerve during thyroidectomy: a comparative study on 1000 nerves at risk. Surgery 2006; 140: 866 - 872.discussion 872-873.
18. Shindo M, Chheda NN., Incidence of vocal cord paralysis with and without recurrent laryngeal nerve monitoring during thyroidectomy. Arch Otolaryngol Head Neck Surg 2007; 133: 481 - 485.
19. Barczynski M, Konturek A, Cichon S., Randomized clinical trial of visualization versus neuromonitoring of recurrent laryngeal nerves during thyroidectomy. Br J Surg 2009; 96: 240 - 246.
20. Timmerman W, Hammelamnn W., Thyroid surgery: neuromonitoring of the RLN during thyroid surgery. Dtsch Arztebl 2004; 101: 7.
21. Thomusch O, Sekulla C, Machens A, Neumann HJ, Timmermann W, Dralle H., Validity of intraoperative neuromonitoring signals in thyroid surgery. Langenbecks Arch Surg 2004; 389: 499 - 503.
22. Beldi G, Kinsbergen T, Schlumpf R., Evaluation of intraoperative recurrent nerve monitoring in thyroid surgery. World J Surg 2004; 28: 589 - 591.
23. Chan WF, Lo CY., Pitfalls of intraoperative neuromonitoring for predicting postoperative recurrent laryngeal nerve function during thyroidectomy. World J Surg 2006; 30: 806 - 812.
24. Dionigi G, Bacuzzi A, Boni L, Rovera F, Dionigi R., What is the learning curve for intraoperative neuromonitoring in thyroid surgery? Int J Surg 2008; 6 (suppl 1): S7 - S12.
25. Hermann M, Hellebart C, Freissmuth M., Neuromonitoring in thyroid surgery: prospective evaluation of intraoperative electrophysiological responses for the prediction of recurrent laryngeal nerve injury. Ann Surg 2004; 240: 9 - 17.
26. Dralle H, Sekulla C, Lorenz K, Brauckhoff M, Machens A., German IONM Study Group: Intraoperative monitoring of the recurrent laryngeal nerve and thyroid surgery. World J Surg 2008; 32: 1358 - 1366.
27. White WM, Randolph GW, Hartnick CJ, Cunningham MJ., Recurrent laryngeal nerve monitoring during thyroidectomy and related cervical procedures in the pediatric population. Arch Otolaryngol Head Neck Surg 2009; 135: 88 - 94.
28. Randolph GW., Surgical anatomy of the recurrent laryngeal nerve. In:, Randolph GW, ed. Surgery of the Thyroid and Parathyroid Glands. Philadelphia, PA: Saunders; 2003: 300 - 349.
29. Mihai R, Randolph, GW., Thyroid surgery, voice and the laryngeal examination- time for increased awareness and accurate evaluation. World J Endocr Surg 2009; 1: 1 - 5.
30. Randolph GW, Kamani D., The importance of preoperative laryngoscopy in patients undergoing thyroidectomy: voice, vocal cord function, and the preoperative detection of invasive thyroid malignancy. Surgery 2006; 139: 357 - 362.
31. James AG, Crocker S, Woltering E, Ferrara J, Farrar W., A simple method for identifying and testing the recurrent laryngeal nerve. Surg Gynecol Obstet 1985; 161: 185 - 186.
32. Otto RA, Cochran CS., Sensitivity and specificity of intraoperative recurrent laryngeal nerve stimulation in predicting postoperative nerve paralysis. Ann Otol Rhinol Laryngol 2002; 111: 1005 - 1007.
33. Riddell V., Thyroidectomy: prevention of bilateral recurrent nerve palsy: results of identification of the nerve over 23 consecutive years (1946-69) with a description of an additional safety measure. Br J Surg 1970; 57: 1 - 11.
34. Premachandra DJ, Radcliffe GJ, Stearns MP., Intraoperative identification of the recurrent laryngeal nerve and demonstration of its function. Laryngoscope 1990; 100: 94 - 96.
35. Scheuller MC, Ellison D., Laryngeal mask anesthesia with intraoperative laryngoscopy for identification of the recurrent laryngeal nerve during thyroidectomy. Laryngoscope 2002; 112: 1594 - 1597.
36. Woltering EA, Dumond D, Ferrara J, Farrar WB, James AG., A method for intraoperative identification of the recurrent laryngeal nerve. Am J Surg 1984; 148: 438 - 440.
37. Lipton RJ, McCaffrey TV, Litchy WJ., Intraoperative electrophysiologic monitoring of laryngeal muscle during thyroid surgery. Laryngoscope 1988; 98: 1292 - 1296.
38. Rice DH, Cone- Wesson B., Intraoperative recurrent laryngeal nerve monitoring. Otolaryngol Head Neck Surg 1991; 105: 372 - 375.
39. Tschopp K, Probst R., New aspects in surgery of the thyroid gland with intraoperative monitoring of the recurrent laryngeal nerve. Laryngorhinootologie 1994; 73: 568 - 572.
40. Jonas J, Bahr R., Neuromonitoring of the external branch of the superior laryngeal nerve during thyroid surgery. Am J Surg 2000; 179: 234 - 236.
41. Tschopp KP, Gottardo C., Comparison of various methods of electromyographic monitoring of the recurrent laryngeal nerve in thyroid surgery. Ann Otol Rhinol Laryngol 2002; 111: 811 - 816.
42. Eisele DW., Intraoperative electrophysiologic monitoring of the recurrent laryngeal nerve. Laryngoscope 1996; 106: 443 - 449.
43. Barwell J, Lytle J, Page R, Wilkins D., The NIM- 2 nerve integrity monitor in thyroid and parathyroid surgery. Br J Surg 1997; 84: 854.
44. Horn D, Rotzscher VM., Intraoperative electromyogram monitoring of the recurrent laryngeal nerve: experience with an intralaryngeal surface electrode. A method to reduce the risk of recurrent laryngeal nerve injury during thyroid surgery. Langenbecks Arch Surg 1999; 384: 392 - 395.
45. Timon CI, Rafferty M,. Nerve monitoring in thyroid surgery: is it worthwhile? Clin Otolaryngol Allied Sci 1999; 24: 487 - 490.
46. Lamade W, Meyding- Lamade U, Buchhold C, et al. First continuous nerve monitoring in thyroid gland surgery. Chirurg 2000; 71: 551 - 557.
47. Hemmerling TM, Schmidt J, Wolf T, Wolf SR, Jacobi KE., Surface vs intramuscular laryngeal electromyography. Can J Anaesth 2000; 47: 860 - 865.
48. 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: 537 - 543.
49. Rea L, Kahn A., Clinical evoked electromyography for current laryngeal nerve preservation: use of an endotracheal tube electrode in a postcricoid surface electrode. Laryngoscope 1998; 108: 1418 - 1420.
50. Marcus B, Edwards B, Yoo S, et al. Recurrent laryngeal nerve monitoring in thyroid and parathyroid surgery: the University of Michigan experience. Laryngoscope 2003; 113: 356 - 361.
51. Scott AR, Chong PS, Hartnick CJ, Randolph GW., Spontaneous and evoked laryngeal electromyography of the thyroarytenoid muscle: a canine model for intraoperative recurrent laryngeal nerve monitoring. Ann Rhinol Laryngol 2010; 119: 54 - 63.
52. Scott AR, Chong PS, Brigger M, Randolph GW, Hartnick CJ., Serial electromyography of the thyroarytenoid muscles in a canine model of vocal fold paralysis. Ann Otol Rhinol Laryngol 2009; 118: 56 - 66.
53. Sloan TB, Erian R., Effect of atracurium- induced neuromuscular block on cortical motor- evoked potentials. Anesth Analg 1993; 76: 979 - 984. (Pubitemid 23139447)
54. Sloan TB., Anesthesia and intraoperative neurophysiological monitoring in children. Childs Nerv Syst 2010; 26: 227 - 235.
55. Marusch F, Hussock J, Haring G, Hachenberg T, Gastinger I., Influence of muscle relaxation on neuromonitoring of the recurrent laryngeal nerve during thyroid surgery. Br J Anaesth 2005; 5: 596 - 600.
56. Bragg P, Fisher DM, Shi J, Donati F, Meistelman C, Lau M, Sheiner LB., Comparison of twitch depression of the adductor pollicis and the respiratory muscles. Anesthesiology 1994; 80: 310 - 319.
57. Meistelman C., Effects on laryngeal muscles and intubating conditions with new generation muscles relaxants. Acta Anaesthesiol Belg 1997; 48: 11 - 14.
58. Chu KS, Wu SH, Lu IC, et al. Feasibility of intraoperative neuromonitoring during thyroid surgery after administration of nondepolarizing neuromuscular blocking agents. World J Surg 2009; 33: 1408 - 1413.
59. Lu IC, Chu KS, Tsai CJ, et al. Optimal depth of NIM EMG endotracheal tube for IONM of the RLN during thyroidectomy. World J Surg 2008; 32: 1935 - 1939.
60. Cherng CH, Wong CS, Hsu CH, Ho ST., Airway length in adults: estimation of the optimal endotracheal for orotracheal intubation. Clin Anesthes 2002; 14: 271 - 274.
61. Yap SJ, Morris RW, Pybus DA., Alterations in endotracheal tube position during general anesthesia. Anaesthesia Intensive Care 1994; 22: 586 - 588.
62. Kim JH, Hong DM, Oh AY, Han SH., Tracheal shortening during laparoscopic gynecologic surgery. Acta Anesthesiol Scand 2007; 51: 235 - 238.
63. Jin- Hee K, Ro YJ, Seong- Won M, et al. Elongation of the trachea during neck extension in children: implications of the safety of endotracheal tubes. Anesth Analg 2005; 101: 974 - 977.
64. Chiang FY, Lu IC, Kuo WR, Lee KW, Chang NC, Wu CW., The mechanism of recurrent laryngeal nerve injury during thyroid surgery: the application of intraoperative neuromonitoring. Surgery 2008; 143: 743 - 749.
65. Randolph GW, Kobler JB, Wilkins J., Recurrent laryngeal nerve identification during thyroid surgery: laryngeal palpation. World J Surg 2004; 28: 755 - 760.
66. Snyder SK, Lairmore TC, Hendricks JC, Roberts JW., Elucidating mechanisms of recurrent laryngeal nerve injury during thyroidectomy and parathyroidectomy. J Am Coll Surg 2008; 206: 123 - 130.
67. Blitzer A, Crumley RL, Dailey SH, et al. Recommendations of the Neurolaryngology Study Group on laryngeal electromyography. Otolaryngol Head Neck Surg 2009; 140: 782 - 793.
68. ACNS guidelines for evoked potentials 9A. Available at: Accessed February 10, 2006.
69. Schwartz DM, Berry GA., Normative aspects of the ABR. In:, Jacobson JT, ed. The Auditory Brainstem Response. San Diego, CA: College Hill Press; 1985: 65 - 97.
70. Koester M, Zorowka P, Wolf S., Neuromonitoring in thyroid surgery: the view of the laryngologist. Eur Surg 2003; 35: 246 - 249.