未经证实:喉返神经(RLN)损伤是颈前路椎间盘切除融合术(ACDF)后常见的并发症。在本研究中,我们使用肌电图-气管导管(EMG-ET)术中RLN监测评估ACDF手术期间的RLN功能.
未经批准:在本研究中,我们回顾性比较了2017年3月至2022年3月在Vajira医院接受ACDF和EMG-ET的患者的术后RLN损伤结局.
未经评估:分析包括85名患者,其中58人(68.2%)在没有EMG-ET的情况下接受了手术,27人(31.8%)进行了EMG-ET。在无EMG-ET组中,8例(13.8%)和1例(1.7%)患者术后立即出现吞咽困难和声音嘶哑,分别,在12个月内完全恢复。在EMG-ET组中,2例(7.4%)和1例(3.7%)患者出现吞咽困难和声音嘶哑,分别,所有3名患者在3个月内完全恢复。5例无EMG-ET患者(8.6%)发生了持续的术后RLN麻痹,但无EMG-ET患者发生。术中使用EMG-ET检测潜在RLN损伤的敏感性和特异性分别为67.0%和96.0%,分别。EMG-ET的使用缩短了牵开器时间(P=0.003),牵开器时间<70分钟与术后RLN损伤发生率降低相关(比值比,0.122;95%置信区间,0.015-0.981;P=0.048)。
UNASSIGNED:在ACDF手术期间使用EMG-ET进行RLN监测有助于检测术后RLN损伤,具有良好的敏感性和高特异性,并导致更短的牵开时间,从而显著降低术后RLN损伤的风险。
UNASSIGNED: Recurrent laryngeal nerve (RLN) injury is common complication after anterior cervical discectomy and fusion (ACDF). In the present study, we evaluated RLN function during ACDF surgery using intraoperative RLN monitoring with an electromyography-endotracheal tube (EMG-ET).
UNASSIGNED: In the present study, we retrospectively compared the postoperative RLN injury outcomes between patients who had undergone ACDF with and without an EMG-ET at Vajira Hospital from March 2017 to March 2022.
UNASSIGNED: The analysis included 85 patients, 58 (68.2%) of whom had undergone surgery without an EMG-ET and 27 (31.8%) with an EMG-ET. Of the no EMG-ET group, 8 (13.8%) and 1 (1.7%) patient had developed immediate postoperative dysphagia and hoarseness, respectively, with complete recovery within 12 months. In the EMG-ET group, 2 (7.4%) and 1 (3.7%) patient had developed dysphagia and hoarseness, respectively, with complete recovery within 3 months for all 3 patients. Persistent postoperative RLN palsy had occurred in 5 patients (8.6%) without the EMG-ET but in none of the patients with the EMG-ET. The sensitivity and specificity for the use of intraoperative EMG-ET to detect a potential RLN injury were 67.0% and 96.0%, respectively. The use of an EMG-ET reduced the retractor time (P = 0.003), and a retractor time of <70 minutes was associated with a decreased incidence of postoperative RLN injury (odds ratio, 0.122; 95% confidence interval, 0.015-0.981; P = 0.048).
UNASSIGNED: The use of an EMG-ET for RLN monitoring during ACDF surgery was helpful in detecting postoperative RLN injury with fair sensitivity and high specificity and resulted in a shorter retractor time, thereby significantly reducing the risk of postoperative RLN injury.