Romo-Magdaleno JA, Torres-Alarcón CG, López-Chavira A, Pacheco-Ramírez MA, Rivera-Martínez CG, Moreno-Reynoso AS, Mateos-Aguilar OO

Language: Spanish
References: 16
Page: 59-67
PDF size: 239.91 Kb.

ABSTRACT

Background: The reference pattern to avoid recurrent laryngeal nerve injury is direct visualization and monitoring was designed to facilitate identification and assess the functional status of the nerve during surgery.
Objective: To know the number and type of errors in the technique of neuromonitoring of the recurrent laryngeal nerve.
Material and Method: A prospective, cross-sectional, descriptive and observational study was done in which patients undergoing thyroid surgery were included during the period from August to October 2016. The prospective evaluation of the patients consisted in monitoring the recurrent laryngeal nerve with the nerve integrity system NIM 3.0, Medtronic Xomed^®, after the visual identification of the upper laryngeal nerve and vagus nerve. The data was analyzed with the statistical program SPSS Statistics 21.
Results: There were included 34 nerves in risk; 44.1% of the recurrent laryngeal nerves at risk were successfully monitored. The most frequently identified error was the absence of recording the intensity of the wave in step V1 in 35.1% of the recurrent laryngeal nerves at risk, followed by the wave intensity in V2 in 32.4%; administration of muscle relaxant in 14.7% and inadequate placement of the electrodes in 11.8%. There were 6 cases of chordal paralysis, with loss of signal in 5 of them and a false negative, the positive predictive value was 62.5% and the negative predictive value of 96.1%.

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