A new vagal anchor electrode for real-time monitoring of the recurrent laryngeal nerve.
BACKGROUND
Despite conventional neuromonitoring, the recurrent laryngeal nerve (RLN) is still at risk for damage during thyroid surgery. The feasibility of continuous RLN monitoring by vagal nerve (VN) stimulation with a new anchor electrode should be shown, and electromyographic signal alterations of stressed RLN were analyzed to be alerted to imminent nerve failure whereby the nerve damage becomes reversible.


METHODS
VN stimulation was achieved in 23 pigs. Sensed signals were analyzed and stored as real-time audio/video feedback EMG system. RLN was stressed by mechanical and thermal injury; signal alterations were evaluated.


RESULTS
VNs were successfully real-time stimulated by using the anchor electrode. No complications or side effects during stimulation were detected. RLN injury led to an alteration of signal amplitude and latency period but signal restitution after injury.


CONCLUSIONS
Real-time monitoring of the RLN is technically feasible to perceive imminent nerve failure. The anchor electrode was safely and easy to handle. Its implementation is being tested in an ongoing clinical trial.
Schneider
Rick
R
University Hospital Leipzig, Department of Surgery, Liebigstr 20, Leipzig 04013, Germany.
Przybyl
Joanna
J
Pliquett
Uwe
U
Hermann
Michael
M
Wehner
Markus
M
Pietsch
Uta-Carolin
UC
König
Fritjoff
F
Hauss
Johann
J
Jonas
Sven
S
Leinung
Steffen
S
D000818:Animals; D004558:Electric Stimulation / Q000379:methods; D004566:Electrodes; D004576:Electromyography / Q000379:methods; D005240:Feasibility Studies; D016343:Monitoring, Intraoperative / Q000379:methods*; D061226:Recurrent Laryngeal Nerve Injuries; D013552:Swine; D013959:Thyroid Diseases / Q000601:surgery*; D014630:Vagus Nerve