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Jefferson Walter Daniel, Ricardo Vieira Botelho, Jerônimo Buzetti Milano, Fernando Rolemberg Dantas, Franz Jooji Onishi, Eloy Rusafa Neto, Eduardo de Freitas Bertolini, Marcelo Antonio Duva Borgheresi, Andrei Fernandes Joaquim
STUDY DESIGN: Systematic literature review and meta-analysis. OBJECTIVE: The objective of this systematic literature review was to evaluate if intraoperative neurophysiological monitoring (IONM) can prevent neurological injury during spinal operative surgical procedures. SUMMARY OF BACKGROUND DATA: IONM seems to have presumable positive effects in identifying neurological deficits. However, the role of IONM in the decrease of new neurological deficits remains unclear...
August 2018: Spine
Sanghyun Han, Yong Chul Kwon, Sung-Min Kim, Seung-Jae Hyun, Tae-Ahn Jahng, Ki-Jeong Kim, Hyun-Jib Kim, Kyung Seok Park, Ho Yong Choi, Young-Seop Park
OBJECTIVE: The aim of study is to determine the risk factors affecting intraoperative neurophysiological monitoring (IONM) changes, when such changes take place, and clinical outcomes associated with IONM change during cervical open-door laminoplasty (COL) for cervical compressive myelopathy (CCM). METHODS: Between 2010 and 2015, 79 patients who underwent COL with IONM recording were studied. Changes in MEPs or SSEPs over an alarm criterion were defined as IONM change...
July 23, 2018: World Neurosurgery
Naresh Kumar, Vijayaraghavan G, Nivetha Ravikumar, Yan Ding, May Lin Yin, Ravish Shammi Patel, Nandika Naresh, Hwee Weng Hey Denis, Lau Leok Lim, Liu Ka Po Gabriel
STUDY DESIGN: Retrospective OBJECTIVE.: We aim to report our experience with multimodal Intraoperative neuromonitoring (IONM) in Metastatic Spine Tumour Surgery (MSTS). SUMMARY OF BACKGROUND DATA: IONM is considered as standard of care in spinal deformity surgeries. However, limited data exist about its role in MSTS. METHODS: A total of 135 patients from 2010 to 2017, who underwent MSTS with IONM at our institute were studied retrospectively...
July 23, 2018: Spine
Gunay Gurleyik, Mehmet Torun, Emin Gurleyik
Complication-free thyroid surgery is mainly based on the motor integrity of the recurrent laryngeal nerve (RLN). The nonrecurrent laryngeal nerve (non-RLN) is a rare anatomical variation that may increase the risk of vocal cord palsy. Early identification and exposure of the non-RLN may minimize injury risk. This case report presents functional detection of the non-RLN by intraoperative neuromonitoring (IONM). Total thyroidectomy was performed under the guidance of IONM on a patient with bulky multinodular goiter...
May 22, 2018: Curēus
Che-Wei Wu, Feng-Yu Chiang, Gregory W Randolph, Gianlorenzo Dionigi, Hoon Yub Kim, Yi-Chu Lin, Tzu-Yen Huang, Chiao-I Lin, Pao-Chu Hun, Dipti Kamani, Pi-Ying Chang, I-Cheng Lu
BACKGROUND: Recurrent laryngeal nerves (RLN) palsy remains a major source of morbidity after thyroid surgeries. Intraoperative neural monitoring (IONM) has gained increasing acceptance as an adjunct to standard practice of visual RLN identification. Endotracheal tube (ETT) surface recording electrodes systems are now widely used for IONM, however, a malpositioned ETT can cause false IONM results and requires time-consuming intraoperative verification of the ETT position and readjustment by the anesthesiologist...
July 20, 2018: Thyroid: Official Journal of the American Thyroid Association
Nan Zhang, Zhengda Yu, N U Farrukh Hameed, Geng Xu, Yanyan Song, Bin Wu, Jie Zhang, Tianming Qiu, Dongxiao Zhuang, Junfeng Lu, Jinsong Wu
OBJECTIVE: To evaluate long-term functional and survival outcomes of glioma patients following intraoperative neurophysiological monitoring (IONM) application. METHODS: 856 glioma patients, who underwent tumor resection between October 2010 and March 2016, were included in this retrospective cohort study. All patients were stratified into IONM (439 cases) and non-IONM group (417 cases). The primary outcome measured was overall survival (OS), and the secondary outcome measured was rate of late neurologic deficits...
July 16, 2018: World Neurosurgery
Rogean R Nunes, Carlos D A Bersot, João G Garritano
PURPOSE OF REVIEW: The purpose of this review is to highlight the importance of making informed choices of anesthetics and evaluating the impact of depth of anesthesia, hemodynamic status and other factors capable of interfering with signal capture during intraoperative neurophysiological monitoring (IONM). RECENT FINDINGS: Over the last decades, neuromonitoring has advanced considerably, allowing for insights into neurological function during anesthesia and making it possible to assess intraoperative consciousness and neural integrity in real time...
July 16, 2018: Current Opinion in Anaesthesiology
A F Engelsman, S Warhurst, S Fraser, D Novakovic, S B Sidhu
Background: Integrity of the recurrent laryngeal nerve (RLN) and the external branch of the superior laryngeal nerve (EBSLN) can be checked by intraoperative nerve monitoring (IONM) after visualization. The aim of this study was to determine the prevalence and nature of voice dysfunction following thyroid surgery with routine IONM. Methods: Thyroidectomies were performed with routine division of strap muscles and nerve monitoring to confirm integrity of the RLN and EBSLN following dissection...
June 2018: BJS open
M W Pei, W B Chen, M R Hu
Recurrent laryngeal nerve (RLN) injury is a serious complication of thyroidectomy. Intraoperative neuro-monitoring(IONM) is a technology for identifying the integrity of nerves during operation by electrophysiological means, which included the intermitted IONM and the continuous IONM.This paper aims to compare the superiorities and defects of both IONM methods and summarize the current state and progress of IONM.
June 7, 2018: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Daqi Zhang, Qingfeng Fu, Gianlorenzo Dionigi, Tie Wang, Jingwei Xin, Jiao Zhang, Gaofeng Xue, Hongbo Li, Hui Sun
OBJECTIVE: The aim of this report was dual: (a) to describe the step by step standardized intraoperative neural monitoring (IONM) procedure for recurrent laryngeal nerve (RLN) and external branch of the superior laryngeal nerve focusing on percutaneous IONM method, and (b) evaluation and outcomes of intermittent IONM in 237 endoscopic thyroidectomy via bilateral areolar approach cases. MATERIALS AND METHODS: A 10-mm curved incision is made along the margin of the right areola at the 2 to 4 o'clock position for the 30-degree endoscope...
June 7, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Hiroyuki Kobayashi, Masato Kondo, Motoko Mizumoto, Hiroki Hashida, Satoshi Kaihara, Ryo Hosotani
BACKGROUND: Because the thoracic esophageal carcinoma has a high metastatic rate to the upper mediastinal lymph nodes, especially along the recurrent laryngeal nerves (RLN), it is crucial to perform a complete lymphadenectomy along the RLN without complications. Although intraoperative neural monitoring (IONM) during thyroid surgery has gained widespread acceptance as a useful tool for visual nerve identification, utilization of IONM during esophageal surgery has not become common. Here, we describe our procedures, focusing on a lymphadenectomy along the RLN utilizing the IONM...
June 5, 2018: International Journal of Surgery
Lilia Cristina De la Maza-Krzeptowsky, Gabriela Romero-Esquiliano, Eduardo H Ramírez-Segura, Enrique De Obieta-Cruz, Alfonso Vega-Sosa, Alexander Cárdenas-Mejía, Daniel San Juan-Orta, Margot Castillo-Herrera, Sergio J Aguilar-Castillo, Mario U Ávila-Ordóñez, Luz M Cordero-Guzmán, Rosa E Escobar-Cedillo, María I Fraire-Martínez, Marisela O Franco-Lira, José J González-Jaime, Claudia E Paz-Navarro, Jaime N Ramos-Peek, Paul Shkurovich-Bialik, Pedro Silva-Cerecedo, C Armando Tello-Valdés, Álvaro A Zavala-Reina, Jaime López-Rodríguez, Ojino Sosa-García
Introduction: Intraoperative neurophysiological monitoring (IONM) is a procedure that uses neurophysiological techniques in order to evaluate the motor and sensitive systems during surgeries that endanger the nervous system. Method: The approach, scope, target population, and clinical questions to be answered were defined. A systematic search of the evidence was conducted step by step; during the first stage, clinical practice guidelines were collected, during the second stage systematic reviews were obtained, and during the third stage, clinical trials and observational studies were procured...
2018: Cirugia y Cirujanos
Francesco Tomasello, Filippo Flavio Angileri, Alfredo Conti, Antonino Scibilia, Salvatore Cardali, Domenico La Torre, Antonino Germanò
BACKGROUND: Petrous meningiomas (PMs) represent a subset of posterior fossa tumors accounting for ∼8% of all intracranial meningiomas. Surgical treatment of PMs is challenging because of their relationships with vital neurovascular structures of the cerebellopontine angle. OBJECTIVE: To investigate independent pre- and intraoperative predictors of PM surgery outcome. METHODS: We reviewed the surgical and outcome data of patients who underwent microsurgical resection of PMs from 1997 to 2016...
May 22, 2018: Neurosurgery
Emin Gurleyik
Introduction Anatomical studies on human cadavers have established anastomoses between laryngeal nerves. However, we need to functionally identify motor communication via these anastomoses between the recurrent laryngeal nerve (RLN) and the external branch of the superior laryngeal nerve (EBSLN) in living bodies. We aim to establish motor interconnections using intraoperative nerve monitoring (IONM). Methods IONM of 112 EBSLNs and RLNs in 62 thyroidectomy cases was used to establish motor functions of laryngeal nerves...
March 16, 2018: Curēus
Binglong Bai, Wuzhen Chen
Recurrent laryngeal nerve (RLN) injury is an intractable complication of thyroidectomy. Intraoperative nerve monitoring (IONM) was designed to prevent RLN injury. However, the results concerning the protective effect of IONM on RLN injury are still controversial. We searched all eligible databases from 1980 to 2017. Meta-analysis was performed to evaluate the effect of IONM on RLN injury. Sensitivity analysis was also conducted to check the stability of our results. There were 34 studies included in the analysis...
May 17, 2018: Scientific Reports
Daqi Zhang, Shijie Li, Gianlorenzo Dionigi, Tie Wang, Jiao Zhang, Gaofeng Xue, Hui Sun
BACKGROUND: Experimental study to evaluate feasibility of continuous intraoperative neural monitoring (C-IONM) in transoral endoscopic thyroidectomy vestibular approach (TOETVA). METHODS: Duroc-Landrace pigs were orally intubated with electromyogram endotracheal tube. Automatic periodic stimulation (APS) electrode was allocated in the operative field through the 5-mm ports. APS was then repose on vagal nerve (VN) with different approaches: (1) median, that is, between sternothyroid and thyroid gland; and (2) lateral, that is, between sternocleidomastoid and sternothyroid...
May 10, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Zhibao Li, Mingran Wang, Liwei Zhang, Xing Fan, Xiaorong Tao, Lei Qi, Miao Ling, Xiong Xiao, Yuliang Wu, Dongze Guo, Hui Qiao
OBJECTIVE: To evaluate a new technique in brainstem surgery, neuronavigation (NN)-guided corticospinal tract (CST) mapping, in a retrospective study of patients undergoing brainstem tumor surgery. METHODS: We studied 40 patients with a brainstem tumor who were enrolled in this study. Patients whose worst preoperative muscle strength of the 4 limbs was greater than 3 levels from normal on the Lovett scale were divided into 2 groups: a treatment group of 21 patients who underwent NN-guided CST mapping and routine intraoperative neurophysiology monitoring (IONM) and a control group of 19 patients who underwent routine NN and IONM...
August 2018: World Neurosurgery
Shujie Wang, Yang Yang, Qiyi Li, Jie Zhu, Jianxiong Shen, Ye Tian, Yong Hu, Zhi Li, Wei Xu, Yang Jiao, Rui Cao, Jianguo Zhang
BACKGROUND: Intraoperative neurologic monitoring (IONM) has become an essential component for decreasing the incidence of spinal cord injury during spine surgeries. Many high-risk surgical maneuvers that result in significant IONM alerts have not been reported systematically. Our objective was to thoroughly summarize some common high-risk surgical points associated with IONM alerts in various spine surgeries. METHODS: Between November 2010 and April 2017, 62 patients with true-positive IONM alerts from 3139 spine surgeries were enrolled...
July 2018: World Neurosurgery
Sandra Dias, Johannes Sarnthein, Elisabeth Jehli, Marian Christoph Neidert, Luca Regli, Oliver Bozinov
BACKGROUND: High-field intraoperative magnetic resonance imaging (MRI) has become increasingly available in neurosurgery centers. There is little experience with combined intraoperative MRI and intraoperative neurophysiologic monitoring (IONM). We report the first series, to our knowledge, of pediatric patients undergoing brain tumor surgery with 3T intraoperative MRI and IONM. METHODS: This pilot study included all consecutive children operated on for brain tumors between October 2013 and April 2016 in whom concomitant intraoperative MRI and somatosensory evoked potentials and motor evoked potentials were used...
July 2018: World Neurosurgery
V E Cortes-Donate, P J Perez-Lorensu, A Garcia-Garcia, Asociacion de Monitorizacion Intraquirurgica Neurofisiologica Espanola Amine Asociacion de Monitorizacion Intraquirurgica Neurofisiologica Espanola Amine, Sociedad Espanola de Neurofisiologia Clinica Senfc Sociedad Espanola de Neurofisiologia Clinica Senfc, Grupo de Trabajo de Monitorizacion Neurofisiologica Intraoperatoria de la Senfc Grupo de Trabajo de Monitorizacion Neurofisiologica Intraoperatoria de la Senfc
Intraoperative neurophysiological monitoring (IONM) is nowadays another tool within the operating room that seeks to avoid neurological sequels derived from the surgical act. The Spanish Neurophysiological Intra-Surgical Monitoring Association (AMINE) in collaboration with the Spanish Society of Clinical Neurophysiology (SENFC), and the IONM Working Group of the SENFC has been collecting data in order to know the current situation of the IONM in Spain by hospitals, autonomous communities including the autonomous cities of Ceuta and Melilla, the opinions of the specialists in clinical neurophysiology involved in this topic and further forecasts regarding IONM...
May 1, 2018: Revista de Neurologia
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