title: Nerve monitoring and stimulation during endoscopic neck surgery in the pig.
abstract: OBJECTIVE
  To determine the feasibility of recurrent laryngeal nerve monitoring and stimulation during endoscopic neck surgery in an animal model.
  
  
  METHODS
  Prospective, nonrandomized experimental investigation in a porcine model.
  
  
  METHODS
  Bilateral recurrent laryngeal nerve monitoring and stimulation was accomplished during endoscopic neck surgery in five domestic pigs. Each pig was intubated with an electromyography endotracheal tube. Recurrent laryngeal nerve function was monitored throughout the endoscopic neck surgery with a nerve integrity monitor system. An endoscopic surgical pocket was created in the neck using blunt dissection followed by low-pressure carbon dioxide insufflation. Under direct endoscopic visualization, the trachea, thyroid gland, and associated vasculature were identified. The recurrent laryngeal nerve was identified on each side of the animal and was successfully stimulated with a monopolar stimulator probe.
  
  
  RESULTS
  Ten of ten recurrent laryngeal nerves were successfully monitored and stimulated. No significant complications were encountered during the procedures.
  
  
  CONCLUSIONS
  Recurrent laryngeal nerve monitoring and stimulation may be successfully accomplished during endoscopic neck surgery.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
authors.forename: Lisa Danielle
authors.initials: LD
authors.lastname: Grunebaum
authors.forename: David
authors.initials: D
authors.lastname: Rosen
authors.forename: Howard D
authors.initials: HD
authors.lastname: Krein
authors.forename: William M
authors.initials: WM
authors.lastname: Keane
authors.forename: Mark
authors.initials: M
authors.lastname: Curtis
authors.forename: Debra A
authors.initials: DA
authors.lastname: Tereschuk
authors.forename: Edmund A
authors.initials: EA
authors.lastname: Pribitkin
mesh_terms: D000818:Animals; D001706:Biopsy; D002245:Carbon Dioxide / Q000008:administration & dosage; D004210:Dissection; D004558:Electric Stimulation / Q000379:methods*; D004576:Electromyography; D004724:Endoscopy; D005240:Feasibility Studies; D005260:Female; D007327:Insufflation; D007442:Intubation, Intratracheal; D023421:Models, Animal; D016343:Monitoring, Intraoperative / Q000379:methods*; D009333:Neck / Q000601:surgery*; D009334:Neck Muscles / Q000601:surgery; D012009:Recurrent Laryngeal Nerve / Q000033:anatomy & histology / Q000502:physiology*; D013552:Swine; D013961:Thyroid Gland / Q000033:anatomy & histology; D013965:Thyroidectomy / Q000379:methods; D014132:Trachea / Q000033:anatomy & histology; D014827:Vocal Cords / Q000033:anatomy & histology
chemical_list: D002245:Carbon Dioxide