The Laryngoscope · 2016
Supramaximal neurostimulation with laryngeal palpation to predict postoperative vocal fold mobility.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Cha Wonjae, Cho Ilyoung, Jang Jeon Yeob, Cho Jae-Keun, Wang Soo-Geun, Park Ji-Hwan
Аннотация
OBJECTIVES/HYPOTHESIS: Recurrent laryngeal nerve (RLN) injury during thyroidectomy or parathyroidectomy is a challenging issue and causes significant morbidity. We adopted the supramaximal stimulation protocol for neurostimulation with laryngeal palpation (NSLP) and tried to evaluate the predictive values of supramaximal NSLP for immediate postoperative vocal fold (VF) mobility.
STUDY DESIGN: Prospective cohort study.
METHODS: Prospectively, 293 patients who underwent thyroid and parathyroid surgery and 542 RLNs at risk were enrolled in this study. During NSLP, the current was escalated to 3 mA until definite laryngeal twitch was observed. Immediate postoperative VF mobility was evaluated using flexible laryngoscopy.
RESULTS: Diagnostic accuracy of NSLP is calculated according to cutoff values of minimal current intensity (1 mA, 1.5 mA, and 2 mA). At 2mA, sensitivity was 81.82%, specificity 100%, positive predictive value 100%, and negative predictive value 99.62%.
CONCLUSIONS: Supramaximal NSLP might be a simple and reliable method to predict immediate postoperative VF mobility in open thyroid and parathyroid surgeries when intraoperative neuromonitoring is unavailable.
LEVEL OF EVIDENCE: 4. Laryngoscope, 126:2863-2868, 2016.
STUDY DESIGN: Prospective cohort study.
METHODS: Prospectively, 293 patients who underwent thyroid and parathyroid surgery and 542 RLNs at risk were enrolled in this study. During NSLP, the current was escalated to 3 mA until definite laryngeal twitch was observed. Immediate postoperative VF mobility was evaluated using flexible laryngoscopy.
RESULTS: Diagnostic accuracy of NSLP is calculated according to cutoff values of minimal current intensity (1 mA, 1.5 mA, and 2 mA). At 2mA, sensitivity was 81.82%, specificity 100%, positive predictive value 100%, and negative predictive value 99.62%.
CONCLUSIONS: Supramaximal NSLP might be a simple and reliable method to predict immediate postoperative VF mobility in open thyroid and parathyroid surgeries when intraoperative neuromonitoring is unavailable.
LEVEL OF EVIDENCE: 4. Laryngoscope, 126:2863-2868, 2016.