Tiroid ve paratiroid cerrahisinde intraoperatif nöromonitörizasyon uygulamasında iğne elektrot ve yüzey elektrotlu endotrakeal tüp kullanımının karşılaştırılması

Erman Alçı

doi:10.19161/etd.1194656

TR EN

Tiroid ve paratiroid cerrahisinde intraoperatif nöromonitörizasyon uygulamasında iğne elektrot ve yüzey elektrotlu endotrakeal tüp kullanımının karşılaştırılması

Öz

Öz: Amaç: Yüzey elektrotlu endotrakeal tüp kullanılarak yapılan intraoperatif nöromonitörizasyon güvenli ve basit olması sebebiyle günümüzde en yaygın kullanılan teknik haline gelmiştir. Yüzey elektrotlu endotrakeal tüp ile intraoperatif nöromonitörizasyonun, yanlış pozitif sinyal kaybı gibi bazı dezavantajları vardır. Bu nedenle, tiroid kıkırdağına yerleştirilen elektrotlar, tiroaritenoid kasın ve RLS' nin fonksiyonunu değerlendirmek için alternatif bir araçtır. Bu çalışmanın amacı, tiroid ve paratiroid cerrahisinde uygulanan aralıklı intraoperatif nöromonitörizasyon esnasında tiroid kıkırdak iğne elektrotları ve standart endotrakeal tüp yüzey elektrotları beraber kullanılarak eşzamanlı olarak kaydedilen EMG sinyallerinin değerlendirilmesi ve karşılaştırılmasıdır. Gereç ve Yöntem: Bu çalışmada tek merkezde, aralıklı intraoperatif nöromonitörizasyon sisteminin kayıt tarafı olarak hem tiroid kıkırdak iğne elektrotları hem de endotrakeal tüp yüzey elektrotları birlikte kullanılıp eş zamanlı olarak EMG sinyali kaydedilen ilk 21 tiroid ve paratiroid ameliyatının verileri retrospektif olarak analiz edilmiştir. Bulgular: Genel olarak, hem sağ hem de sol tarafta tiroid kıkırdak iğne elektrotlarından kaydedilen EMG genlikleri, her adımda (V1-R1-R2-V2) endotrakeal tüp yüzey elektrotlarından kaydedilenlerden belirgin olarak daha yüksek olarak saptanmıştır (tüm uyarı basamaklarında p<0.05) Sonuç: Her ne kadar endotrakeal tüp yüzey elektrotları Uluslararası Sinir Monitörizasyonu Çalışma Grubu tarafından tiroid ameliyatları sırasında intraoperatif nöromonitörizasyon için önerilen kayıt tarafı yöntemi olsa da, tiroid kıkırdak iğne elektrotları, tiroid cerrahisi sırasında RLS fonksiyonunun monitörize edilmesinde yararlı, basit ve ucuz bir alternatif tekniktir. Anahtar sözcükler: Tiroid kıkırdak iğne elektrotu, endotrakeal tüp yüzey elektrotu, tiroidektomi, rekürren laringeal sinir, intraoperative sinir monitörizasyonu

Anahtar Kelimeler

Comparison of needle electrode and endotracheal tube surface electrode for intraoperative neuromonitoring during thyroid and parathyroid surgery

Abstract

Abstract Aim: Intraoperative neuromonitoring using an endotracheal tube surface electrode has become the most widely used technique due to its safety and simplicity. Intraoperative neuromonitoring with an endotracheal tube surface electrode has some disadvantages, such as false positive loss of signal. Therefore, electrodes on the thyroid cartilage are an alternative means to assess the thyroarytenoid muscle and recurrent laryngeal nerve function. This study aims to evaluate and compare the EMG signals recorded simultaneously using thyroid cartilage needle electrodes and standard endotracheal tube surface electrodes during intermittent intraoperative neuromonitoring in thyroid and parathyroid surgery. Materials and Methods: In this study, the data of the first 21 thyroid and parathyroid surgeries, in which both thyroid cartilage needle electrodes and endotracheal tube surface electrodes were used together as the recording side of the intermittent intraoperative neuromonitoring system in a single center, and EMG signals were recorded simultaneously, were analyzed retrospectively. Results: Overall, EMG amplitudes recorded from thyroid cartilage needle electrodes on both the right and left sides were significantly higher than those recorded from endotracheal tube surface electrodes at each step (V1-R1-R2-V2) (p<0.05 at all stimulation steps) Conclusion: Although the endotracheal tube surface electrodes are generally used for intraoperative neuromonitoring during thyroid and parathyroid surgery and are the recording-side method recommended by the International Neural Monitoring Study Group, the use of thyroid cartilage needle electrodes is an inexpensive, easy, and efficient alternative. Keywords: Thyroid cartilage electrodes, endotracheal tube surface electrodes, thyroidectomy, recurrent laryngeal nerve, intraoperative neural monitoring

Keywords

References

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Details

Primary Language

Turkish

Subjects

General Surgery

Journal Section

Research Article

Authors

Erman Alçı ^*
0000-0002-3846-7285
Türkiye

Publication Date

June 12, 2023

Submission Date

October 26, 2022

Acceptance Date

November 10, 2022

Published in Issue

Year 2023 Volume: 62 Number: 2

DOI

https://doi.org/10.19161/etd.1194656

IZ

https://izlik.org/JA47GG63RP

Cite

RIS / Bibtex

Vancouver

1.Erman Alçı. Tiroid ve paratiroid cerrahisinde intraoperatif nöromonitörizasyon uygulamasında iğne elektrot ve yüzey elektrotlu endotrakeal tüp kullanımının karşılaştırılması. EJM. 2023 Jun. 1;62(2):249-56. doi:10.19161/etd.1194656