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. 2017 Oct;7(4):673-676.
doi: 10.3892/mco.2017.1385. Epub 2017 Aug 18.

Monitoring of recurrent and superior laryngeal nerve function using an Airwayscope™ during thyroid surgery

Kei Ijichi  1 , Hiroshi Sasano  2 , Megumi Harima  2 , Shingo Murakami  1
Affiliations

Monitoring of recurrent and superior laryngeal nerve function using an Airwayscope™ during thyroid surgery

Kei Ijichi et al. Mol Clin Oncol. 2017 Oct.

Abstract

In thyroid surgery, intraoperative identification and preservation of the recurrent laryngeal nerve (RLN) and superior laryngeal nerve external branch (SLNEB) are crucial. Several reports have proposed that electromyography (EMG) monitoring is an acceptable adjunct for identification and preservation of the RLN. However, a limited number of hospitals have access to an EMG monitoring system. Therefore, the development of another viable monitoring method is required. The aim of the present study was to design a new RLN and SLNEB monitoring method combining an Airwayscope™ (AWS) and a facial nerve stimulator. The facial nerve-stimulating electrode stimulates the RLN or SLNEB, so that the movement of the vocal cord may be observed with an AWS. This monitoring method was performed on 10 patients with a thyroid tumor. In all the cases, RLN and SLNEB were identified and vocal cord function was preserved. All the patients exhibited normal vocal cord function following surgery. Thus, the new RLN and SLNEB monitoring method using an AWS and a facial nerve stimulator is useful in thyroid surgery, and this method may be used as a reliable and available alternative to EMG monitoring to ensure the normal function of the vocal cord.

Keywords: Airwayscope™; laryngeal nerve; nerve monitoring; recurrent nerve; thyroid surgery.

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Figures

Figure 1.
Figure 1.
Airwayscope™ (Ricoh, Tokyo, Japan). (A) Frontal and (B) lateral view.
Figure 2.
Figure 2.
Facial nerve stimulator. (A) Main body and (B) stimulating electrode.
Figure 3.
Figure 3.
Setting up nerve monitoring. (A) Stimulation of the recurrent laryngeal nerve with the facial nerve stimulator. (B) Monitoring of vocal cord movement with Airwayscope™.
Figure 4.
Figure 4.
Steps of motor nerve monitoring.
See this image and copyright information in PMC

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