Recurrent Laryngeal Nerve Monitoring in Thyroid Surgery
Neuromonitoring is being advocated for the rapid and reliable identification of the recurrent laryngeal nerve and for predicting the postoperative vocal cord mobility. Neuromonitoring is useful for identifying the recurrent laryngeal nerve, in particularly if the anatomic situation is complicated by previous neck surgery which resulted in significant scarring , large thyroid goiter, aberrant nerve course. Special electrode is connected to the endotracheal tube that located on the surface of the vocal cords, and then connected to an EMG monitor. Using probe, the surgeon can continuously monitor the nerve during a surgical procedure.
This is a screenshot of a response from the Recurrent Laryngeal nerve. The amplitude of this waveform is high and can be easily seen on the graph at 3 ms; the nerve was stimulated at 1 mA
This is a screenshot of a response from the External Branch of the Superior Laryngeal nerve. This low amplitude waveform is small because only a branch of the nerve is being stimulated. Like the recurrent Laryngeal nerve response, the action potential can be seen at 3 ms and nerve was stimulated at 1 mA
External Branch of the Superior Laryngeal Nerve Monitoring in Thyroid Surgery
External branch of the superior laryngeal nerve (EBSLN) is responsible for high pitched voice and voice projection. This is especially important for singers, teachers and public speakers. Monitoring of the external branch of the superior laryngeal nerve is performed during minimally invasive thyroid surgery under local anesthesia or general anesthesia. Special electrodes are used to stimulate the crycothyroid muscle and see response. Monitoring of the external branch of the superior laryngeal nerve helps the surgeon to localize it and preserve it.
Endotracheal (ET) tube with sensor for nerve monitoring during thyroid surgery.
Nerve monitoring during thyroid surgery, computer station.
Dr. Alan Colicchio, M.D. and Dr. Alan Deutsch, D.O. and their group provide service and equipment for the recurrent laryngeal nerve and external branch of the superior laryngeal nerve monitoring during thyroid surgery.
Dr. Alan Colicchio and Dr. Alan Deutsch are both Board Certified in Neurology, they are part of Monmouth-Ocean Neurology, P.C.
1944 Corlies Avenue
Neptune, NJ 07753
Telephone: (732) 774-8282
Fax: (732) 774-6816