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Neuromonitorization

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https://www.readbyqxmd.com/read/28917827/recommendations-on-the-use-of-neuromonitoring-in-thyroid-and-parathyroid-surgery
#1
José Luis Pardal-Refoyo, Pablo Parente-Arias, Marta María Arroyo-Domingo, Juan Manuel Maza-Solano, José Granell-Navarro, Jesús María Martínez-Salazar, Ramón Moreno-Luna, Elvylins Vargas-Yglesias
INTRODUCTION: Thyroid and parathyroid surgery (TPTS) is associated with risk of injury to the recurrent laryngeal nerve, superior laryngeal nerve and voice changes. Intraoperative neuromonitoring (IONM), intermittent or continuous, evaluates the functional state of the laryngeal nerves and is being increasingly used. This means that points of consensus on the most controversial aspects are necessary. OBJECTIVE: To develop a support document for guidance on the use of IONM in TPTS...
September 14, 2017: Acta Otorrinolaringológica Española
https://www.readbyqxmd.com/read/28913601/emergency-neurological-life-support-approach-to-the-patient-with-coma
#2
Rhonda S Cadena, Aarti Sarwal
Coma is an acute failure of neuronal systems governing arousal and awareness and represents a medical emergency. When encountering a comatose patient, the clinician must have an organized approach to detect easily remediable causes, prevent ongoing neurologic injury, and determine a hierarchical plan for diagnostic tests, treatments, and neuromonitoring. Coma was chosen as an Emergency Neurological Life Support protocol because timely medical and surgical interventions can be life-saving, and the initial work-up of such patients is critical to establishing a correct diagnosis...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28899045/recent-advances-in-epilepsy-surgery-and-achieving-best-outcomes-using-high-frequency-oscillations-diffusion-tensor-imaging-magnetoencephalography-intraoperative-neuromonitoring-focal-cortical-dysplasia-and-bottom-of-sulcus-dysplasia
#3
https://www.readbyqxmd.com/read/28895162/laryngeal-emg-preferential-damage-of-the-posterior-cricoarytenoid-muscle-branches-especially-in-iatrogenic-recurrent-laryngeal-nerve-lesions
#4
Gerhard Foerster, Andreas H Mueller
OBJECTIVE: Laryngeal electromyography (LEMG) of the thyroarytenoid (TA) muscle alone may not be sufficient in all patients to characterize or prove a recurrent laryngeal nerve (RLN) lesion in cases of vocal fold immobility. LEMG of the posterior cricoarytenoid (PCA) muscle may provide additional information. STUDY DESIGN: Retrospective review. METHOD: Between 2008 and 2016, 339 patients in our laryngeal paralysis clinic were examined by transcutaneous needle TA-LEMG and, if tolerated, by PCA-LEMG...
September 12, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28840160/investigation-of-data-driven-optical-neuromonitoring-approach-during-general-anesthesia-with-sevoflurane
#5
Gabriela Hernandez-Meza, Meltem Izzetoglu, Ahmet Sacan, Michael Green, Kurtulus Izzetoglu
Anesthesia monitoring currently needs a reliable method to evaluate the effects of the anesthetics on its primary target, the brain. This study focuses on investigating the clinical usability of a functional near-infrared spectroscopy (fNIRS)-derived machine learning classifier to perform automated and real-time classification of maintenance and emergence states during sevoflurane anesthesia. For 19 surgical procedures, we examine the entire continuum of the maintenance-transition-emergence phases and evaluate the predictive capability of a support vector machine (SVM) classifier during these phases...
October 2017: Neurophotonics
https://www.readbyqxmd.com/read/28815342/development-of-a-novel-detachable-magnetic-nerve-stimulator-for-intraoperative-neuromonitoring
#6
Eui-Suk Sung, Jin-Choon Lee, Sung-Chan Shin, Sung-Won Choi, Da-Woon Jung, Byung-Joo Lee
BACKGROUND: Recurrent laryngeal nerve (RLN) palsy is a serious complication of thyroid surgery. During intraoperative neuromonitoring (IONM) of the RLN in thyroid surgery, repeated shifting between surgical instruments and the nerve stimulator is cumbersome and time-consuming. Therefore, we developed a simple detachable magnetic nerve stimulator that may be connected to all metallic surgical instruments. This study aimed to investigate the feasibility and efficacy of this detachable magnetic nerve stimulator for IONM in a porcine model and humans...
August 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28805756/-an-experience-of-neurophysiological-monitoring-in-neurosurgery
#7
A G Vasyatkina, E A Levin, K Yu Orlov, V V Kobozev
AIM: To evaluate the efficacy of neuromonitoring methods in prevention of postoperative neurological complications and estimation of predictive power of intraoperative changes in monitored characteristics. MATERIAL AND METHODS: Retrospective study examined 240 patients, operated in the years 2014-2015 using intraoperative neurophysiological monitoring. One hundred and seventy-three patients suffered from hemispheric lesions and 67 had lesions located in or near the brainstem...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28803174/intraoperative-vascular-neuromonitoring-in-patients-with-subarachnoid-hemorrhage-a-pilot-study-using-combined-laser-doppler-spectrophotometry
#8
Emilija Schmitz, Barbara Bischoff, Dennis Wolf, Hubert Schmitt, Ilker Y Eyupoglu, Karl Roessler, Michael Buchfelder, Björn Sommer
OBJECTIVE: Intraoperative monitoring of cerebral microcirculation in patients with subarachnoid hemorrhage (SAH) may predict the postoperative neurological outcome. In this pilot study, we examined the value of a novel non-invasive real-time measurement technique to detect changes in local microcirculation. METHODS: We used the laser-Doppler spectrophotometry system "Oxygen-to-see(O2C)" in 14 patients with SAH Hunt & Hess grade 2 to 5, who underwent microsurgical clipping of cerebral aneurysms...
August 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28724200/effect-of-memantine-on-serum-levels-of-neuron-specific-enolase-and-on-the-glasgow-coma-scale-in-patients-with-moderate-traumatic-brain-injury
#9
Majid Mokhtari, Hossein Nayeb-Aghaei, Mehran Kouchek, Mir Mohammad Miri, Reza Goharani, Arash Amoozandeh, Sina Akhavan Salamat, Mohammad Sistanizad
Traumatic brain injury (TBI) is a major cause of disability and death globally. Despite significant progress in neuromonitoring and neuroprotection, pharmacological interventions have failed to generate favorable results. We examined the effect of memantine on serum levels of neuron-specific enolase (NSE), a marker of neuronal damage, and the Glasgow Coma Scale (GCS) in patients with moderate TBI. Patients were randomly assigned to the control group (who received standard TBI management) and the treatment group (who, alongside their standard management, received enteral memantine 30 mg twice daily for 7 days)...
July 19, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28713699/transoral-thyroidectomy-why-is-it-needed
#10
REVIEW
Gianlorenzo Dionigi, Matteo Lavazza, Chei-Wei Wu, Hui Sun, Xiaoli Liu, Ralph P Tufano, Hoon Yub Kim, Jeremy D Richmon, Angkoon Anuwong
Transoral thyroidectomy (TOT) represents reasonably the desirable minimally invasive approach to the gland due to the scarless non-visible incisions, the limited distance between the gland and the access that minimize tissue dissection and respect of the surgical anatomical planes. Patients are routinely selected according to an extensive inclusion criteria: (I) ultrasonographically (US) estimated thyroid diameter not larger than 10 cm; (II) US gland volume ≤45 mL; (III) nodule size ≤50 mm; (IV) a benign tumor, such as a thyroid cyst, single-nodular goiter, or multinodular goiter; (V) follicular neoplasm; (VI) papillary microcarcinoma without lymph node metastasis...
June 2017: Gland Surgery
https://www.readbyqxmd.com/read/28703113/role-of-intraoperative-neuromonitoring-of-the-recurrent-laryngeal-nerves-during-thyroid-reoperations-of-recurrent-goiter
#11
Jan Sopiński, Krzysztof Kuzdak, Masoud Hedayati, Krzysztof Kołomecki
Reoperations of the thyroid gland are challenging to any surgeon. Such procedures are technically difficult and involve higher risk of complications than primary procedures. Recurrent laryngeal nerve (RLN) palsy is one of such complications The aim of the study was to evaluate the effectiveness of intraoperative neuromonitoring (IONM) in preventing RLN palsy during recurrent goiter operations. MATERIAL AND METHODS: We retrospectively analyzed the results of thyroid reoperation performed at the Department of Endocrine, General and Vascular Surgery of Medical University of Lodz in the period from January 2014 to June 2016...
June 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28688062/giant-thoracic-discs-treatment-outcome-and-follow-up-of-33-patients-in-a-single-centre
#12
Saurabh Kapoor, Meriem Amarouche, Farah Al-Obeidi, Jean Marie U-King-Im, Nick Thomas, David Bell
PURPOSE: To help guide treatment strategies and create insight into functional outcomes in patients with Giant herniated thoracic discs (GHTD), which are defined as occupying more than 40% of spinal canal. METHODS: Authors did a retrospective analysis of prospective cohort of 33 cases of GHTD, using clinical letters, notes, and telephonic questionnaires to determine their pre and postoperative functional status, surgical details, and complication rates. 16 males and 17 females operated between 2006 and 2014 were included in the study...
July 7, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28687123/dynamics-of-cerebral-perfusion-deficits-after-aneurysmal-sah%C3%A2-%C3%A2-predictive-value-of-early-mtt-for-subsequent-mtt-deterioration
#13
Christian Rubbert, Julian Caspers, Athanasios Konstandinou Petridis, Bernd Turowski, Rebecca May
BACKGROUND AND PURPOSE: The pathogenesis of poor functional outcome after aneurysmal subarachnoid hemorrhage (aSAH) is not fully understood. Microcirculatory dysfunction, which can be indirectly measured by CT perfusion (CTP), is assumed to play a central role. We evaluated the predictive value of early changes in microcirculation for secondary critical perfusion changes. MATERIALS AND METHODS: Out of 351 consecutive aSAH patients, 166 patients with ≥1 CTP within 72h of ictus (early CTP) and ≥3 CTPs in total were included in the retrospective analysis (53...
July 4, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28685438/functional-nirs-measurement-of-cytochrome-c-oxidase-demonstrates-a-more-brain-specific-marker-of-frontal-lobe-activation-compared-to-the-haemoglobins
#14
Isabel de Roever, Gemma Bale, Robert J Cooper, Ilias Tachtsidis
Functional near-infrared spectroscopy (fNIRS) is an increasingly common neuromonitoring technique used to observe evoked haemodynamic changes in the brain in response to a stimulus. The measurement is typically in terms of concentration changes of oxy- (∆HbO2) and deoxy- (∆HHb) haemoglobin. However, noise from systemic fluctuations in the concentration of these chromophores can contaminate stimulus-evoked haemodynamic responses, leading to misinterpretation of results. Short-separation channels can be used to regress out extracerebral haemodynamics to better reveal cerebral changes, significantly improving the reliability of fNIRS...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28682828/criteria-for-intensive-care-admission-and-monitoring-after-elective-craniotomy
#15
Rafael Badenes, Lara Prisco, Armando Maruenda, Fabio S Taccone
PURPOSE OF REVIEW: The current article revises the recent evidence on ICU admission criteria and postoperative neuromonitoring for patients undergoing elective craniotomy. RECENT FINDINGS: Only a small proportion of elective postoperative neurosurgical patients require specific medical interventions and invasive monitoring. Among these, patients undergoing elective craniotomy are frequently admitted to neuro-ICU, specialist postanaesthesia care units or intermediate-level care unit in the postoperative period...
July 5, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28681496/transcutaneous-sacral-nerve-stimulation-for-intraoperative-verification-of-internal-anal-sphincter-innervation
#16
D W Kauff, T Moszkowski, C Wegner, A Heimann, K-P Hoffmann, T B Krüger, H Lang, W Kneist
BACKGROUND: The current standard for pelvic intraoperative neuromonitoring (pIONM) is based on intermittent direct nerve stimulation. This study investigated the potential use of transcutaneous sacral nerve stimulation for non-invasive verification of pelvic autonomic nerves. METHODS: A consecutive series of six pigs underwent low anterior rectal resection. For transcutaneous sacral nerve stimulation, an array of ten electrodes (cathodes) was placed over the sacral foramina (S2 to S4)...
July 6, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28678106/proper-responding-strategies-to-neuromonitoring-alerts-during-correction-step-in-posterior-vertebral-column-resection-patients-with-severe-rigid-deformities-can-reduce-postoperative-neurologic-deficits
#17
Yingsong Wang, Jingming Xie, Zhi Zhao, Tao Li, Ni Bi, Ying Zhang, Zhiyue Shi
STUDY DESIGN: Retrospective study. OBJECTIVE: To analyze the intraoperative neuromonitoring (IOM) changes in posterior vertebral column resection (PVCR) for severe rigid deformity patients, and describe our stepwise responding strategies. SUMMARY OF BACKGROUND DATA: Obvious neurological deficit risk accompanied with PVCR correction has been emphasized repeatedly. METHODS: The records of 46 PVCR patients achieved IOM were reviewed...
July 3, 2017: Spine
https://www.readbyqxmd.com/read/28660303/the-role-of-eeg-recordings-in-children-undergoing-cardiac-surgery-for-congenital-heart-disease
#18
Sascha Meyer, Martin Poryo, Mohammed Shatat, Ludwig Gortner, Hashim Abdul-Khaliq
BACKGROUND: Neurological dysfunction may occur after corrective cardiac surgery using cardio-pulmonary bypass (CPB) with or without circulatory arrest. Different neurophysiological monitoring systems have been employed to detect neurological complications and possible brain injury in infants and children during and after cardiac surgery. The value of Elecetroencephalogram (EEG) in infants and children at risk for neurological sequelae has not been systematically studied. METHODS: Sequential performance of two EEGs before and after cardiac surgery at a tertiary University Hospital to screen for possible brain injury after cardiac surgery in neonates and children undergoing CPB surgery...
June 28, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28658041/utility-of-intraoperative-monitoring-in-the-resection-of-spinal-cord-tumors-an-analysis-by-tumor-location-and-anatomical-region
#19
Nikita Lakomkin, Akshitkumar M Mistry, Scott L Zuckerman, Travis Ladner, Parth Kothari, Nathan John Lee, Blaine Stannard, Raul A Vasquez, Joseph S Cheng
STUDY DESIGN: Retrospective review of institutional data OBJECTIVE.: The aim of this study was to assess the utility of somatosensory-evoked potentials (SSEP) and transcranial electric motor-evoked potentials (MEP) in the resection of spine tumors and evaluate the ability of both single and multi-modal monitoring to predict post-operative neurological deficits. SUMMARY OF BACKGROUND DATA: While the utility of intraoperative monitoring (IOM) is well established in scoliosis and degenerative surgery, studies in spine tumor patients have been limited...
June 27, 2017: Spine
https://www.readbyqxmd.com/read/28647609/a-machine-learning-approach-for-automated-wide-range-frequency-tagging-analysis-in-embedded-neuromonitoring-systems
#20
Fabio Montagna, Marco Buiatti, Simone Benatti, Davide Rossi, Elisabetta Farella, Luca Benini
EEG is a standard non-invasive technique used in neural disease diagnostics and neurosciences. Frequency-tagging is an increasingly popular experimental paradigm that efficiently tests brain function by measuring EEG responses to periodic stimulation. Recently, frequency-tagging paradigms have proven successful with low stimulation frequencies (0.5-6Hz), but the EEG signal is intrinsically noisy in this frequency range, requiring heavy signal processing and significant human intervention for response estimation...
June 22, 2017: Methods: a Companion to Methods in Enzymology
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