UNASSIGNED: A total of 39 patients and 39 RLN and EBSLNs who underwent monitored SMIA thyroidectomy were included. Thyroid gland is revealed and excised anterior to the cervical sheath between the sternal and clavicular heads of the sternocleidomastoid muscle. Standardized intraoperative neuromonitoring (IONM) procedures and postoperative laryngeal examination were performed to audit the SMIA. Following the four-step method, V1, R1, R2, and V2 were monitored and the signal values were recorded. Statistical analysis was used to evaluate the change of IONM amplitude of RLN, combined with the results of laryngoscopy before and after operation to determine the status of RLN. EBSLN injuries were identified from changes in cricothyroid muscle (CTM) twitch and EMG. SMIA video vignette is detailed.
UNASSIGNED: All RLN and EBSLNs [17 on the left and 22 on the right] were monitored in 39 patients [5 men, 34 women; mean age 34.1±8.7 years; mean body mass index 22.5 (±3.0, 17.0-30.8) kg/m2] undergoing SMIA. For RLN of the affected side, we compared the V2 and V1 (1,236±672 vs. 1,240±428, P=0.973), R2 and R1 (1,676±778 vs. 1,656±765, P=0.849) signals separately, and the results were not statistically different (P>0.05). Comparing the V1 (1,240±428 vs. 1,309±395, P=0.601) signals of the bilateral recurrent laryngeal nerve, there was no statistical difference (P>0.05). CTM twitch and EMG were preserved.
UNASSIGNED: The SMIA technique appears feasible. RLN and EBSLN are easier to be exposed during thyroid surgery of SMIA, which is beneficial to the neuroprotection during the operation. At the same time, it can protect the anterior cervical function and improve the cosmetic effect after operation.
UASSIGNED:共39例患者以及39例接受监测的甲状腺SMIA切除术的RLN和EBSLN纳入研究。甲状腺在胸锁乳突肌的胸骨和锁骨头之间的颈鞘前方被发现并切除。进行了标准化的术中神经监测(IONM)程序和术后喉部检查以审核SMIA。按照四步法,监测V1、R1、R2和V2并记录信号值。采用统计学分析评价RLNIONM振幅的变化,结合手术前后喉镜检查结果判断RLN的状态。EBSLN损伤是根据环甲肌(CTM)抽搐和EMG的变化确定的。SMIA视频插图是详细的。
UNASSIGNED:所有RLN和EBSLN[左侧17例,右侧22例]在39例患者中进行了监测[5例男性,34名妇女;平均年龄34.1±8.7岁;平均体重指数22.5(±3.0,17.0-30.8)kg/m2]接受SMIA。对于受影响侧的RLN,我们比较了V2和V1(1,236±672vs.1,240±428,P=0.973),R2和R1(1,676±778vs.1,656±765,P=0.849)信号分别,结果差异无统计学意义(P>0.05)。比较V1(1,240±428与1,309±395,P=0.601)双侧喉返神经信号,差异无统计学意义(P>0.05)。保留了CTM抽搐和EMG。
未经评估:SMIA技术似乎是可行的。在SMIA的甲状腺手术中,RLN和EBSLN更容易暴露,有利于术中神经保护。同时,保护颈椎前路功能,提高术后美容效果。