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Intraoperative monitoring

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https://www.readbyqxmd.com/read/27915063/preoperative-prediction-of-the-location-and-shape-of-the-facial-nerve-in-patients-with-large-vestibular-schwannomas-using-diffusion-tensor-imaging-based-fiber-tracking
#1
Yanyang Zhang, Zhiqi Mao, Penghu Wei, Yazhou Jin, Lin Ma, Jun Zhang, Xinguang Yu
OBJECTIVE: Preserving the facial nerve (FN) during surgery for large vestibular schwannomas (VSs) is challenging because of the unpredictable locations and morphological changes in the FN. Diffusion tensor imaging-based fiber tracking (DTI-FT) has been proposed to preoperatively visualize the FN. This study was performed to evaluate the efficacy of DTI-FT for predicting FN location and shape in patients with large VSs. METHODS: In this prospective study, imaging data from 30 consecutive patients with large VSs were obtained using 3-T magnetic resonance imaging...
November 30, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27913885/effect-of-sensor-location-on-regional-cerebral-oxygen-saturation-measured-by-invos-5100-in-on-pump-cardiac-surgery
#2
Ah-Reum Cho, Jae-Young Kwon, Choongrak Kim, Jung-Min Hong, Christine Kang
PURPOSE: Near-infrared spectroscopy sensors often cannot be attached at the commercially recommended locations because combined use of neurological monitoring systems is common during on-pump cardiac surgery. The primary purpose of this study was to compare the incidence of regional cerebral oxygen desaturation and regional cerebral oxygen saturation values detected using near-infrared spectroscopy between the upper and lower forehead during on-pump cardiac surgery. METHODS: A prospective observational study was conducted with 25 adult patients scheduled for elective on-pump cardiac surgery...
December 2, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27907934/restriction-of-postoperative-joint-loading-in-a-murine-model-of-anterior-cruciate-ligament-reconstruction-botulinum-toxin-paralysis-and-external-fixation
#3
Amir Lebaschi, Xiang-Hua Deng, Nathan W Coleman, Christopher L Camp, Jianchun Zong, Andrew Carbone, Camila B Carballo, Guang-Ting Cong, Zoe M Album, Scott A Rodeo
Control of knee motion in small animal models is necessary to study the effect of mechanical load on the healing process. This can be especially challenging in mice, which are being increasingly used for various orthopedic reconstruction models. We explored the feasibility of botulinum toxin (Botox; Allergan, Dublin, Ireland) paralysis and a newly designed external fixator to restrict motion of the knee in mice undergoing anterior cruciate ligament (ACL) reconstruction. Nineteen C57BL/6 mice were allocated to two groups: (1) Botox group (n = 9) and (2) external fixator group (n = 10)...
December 1, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27903493/cancer-detection-in-human-tissue-samples-using-a-fiber-tip-ph-probe
#4
Erik P Schartner, Matthew R Henderson, Malcolm Purdey, Deepak Dhatrak, Tanya M Monro, P Grantley Gill, David F Callen
Intraoperative detection of tumorous tissue is an important unresolved issue for cancer surgery. Difficulty in differentiating between tissue types commonly results in the requirement for additional surgeries to excise unremoved cancer tissue or alternatively in the removal of excess amounts of healthy tissue. Although pathologic methods exist to determine tissue type during surgery, these methods can compromise postoperative pathology, have a lag of minutes to hours before the surgeon receives the results of the tissue analysis, and are restricted to excised tissue...
December 1, 2016: Cancer Research
https://www.readbyqxmd.com/read/27898550/severe-intraoperative-shock-related-to-mesenteric-traction-syndrome
#5
Alfredo Haack Couto, Hugo Siqueira, Pablo Pulcheira Brasileiro, Ismar Lima Cavalcanti, Rogério Luiz da Rocha Videira
Mesenteric traction syndrome is defined as arterial hypotension, facial flushing, and tachycardia related to mesenteric traction. We describe a case of mesenteric traction syndrome refractory to catecholamine and vasopressin infusions. The patient, who had Crohn disease, developed severe distributive shock after mesenteric traction while undergoing resection of an intestinal inflammatory mass, accompanied by facial flushing and unaltered readings for pulse oximetry, capnography, and bispectral index monitoring...
November 28, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27893549/how-deleterious-is-facial-nerve-dissection-for-the-facial-nerve-in-parotid-surgery-an-electrophysiological-evaluation
#6
Sabri Baki Eren, Remzi Dogan, Orhan Ozturan, Bayram Veyseller, Ayşenur Meriç Hafiz
OBJECTIVE: This study was conducted to investigate subclinical electrophysiological deleterious effect due to microtrauma to the nerve in response to the dissection of a tumor and parotid tissue from the facial nerve and its branches and surgical traction experienced during the operation. METHODS: The study included 34 adult patients who underwent parotidectomy operations under intraoperative facial nerve monitoring. Three measurements were taken from each patient to evaluate facial nerve functions, with 3 stimuli of different intensities applied with different timing...
November 23, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27889777/sodium-pentosan-polysulfate-reduced-renal-ischemia-reperfusion-induced-oxidative-stress-and-inflammatory-responses-in-an-experimental-animal-model
#7
Péter Hardi, Tibor Nagy, Gábor Fazekas, Endre Arató, Gábor Menyhei, György Sétáló, Mónika Vecsernyés, Örs Pintér, Ildikó Takács, Noémi Bohonyi, Gábor Jancsó
Acute kidney injury (AKI) remains an independent risk factor for mortality and morbidity after vascular surgery (affecting the renal arteries) or aortic surgery (requiring suprarenal aortic clamping). These types of vascular surgery produce renal ischemia/reperfusion (I/R) injury, a common cause of AKI. The present studies aimed at monitoring the course of renal I/R injury at the cellular level and investigating the efficacy of long-term preoperative and single-shot intraoperative administration of sodium pentosan polysulfate (PPS) to protect renal tissue from acute I/R injury both in native and diabetic kidneys in rats...
November 26, 2016: Journal of Vascular Research
https://www.readbyqxmd.com/read/27888911/revision-functional-endoscopic-sinus-surgery
#8
REVIEW
Corinna G Levine, Roy R Casiano
Refractory chronic rhinosinusitis can be challenging to treat. Initial treatment focuses on medical and nonsurgical treatments. If these treatments fail, revision endoscopic sinus surgery is an option. A plan for revision surgery must address anatomic factors contributing to recurrence. Preoperative imaging and sinonasal endoscopy are systematically reviewed; areas of disease and "danger" zones are identified. Traditional anatomic landmarks are often obscured or absent; thus, a set of consistent landmarks (unchanged despite prior surgery) are used to navigate the revision endoscopic sinus surgery...
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27888745/feasibility-of-eliciting-the-h-reflex-in-the-masseter-muscle-in-patients-under-general-anesthesia
#9
Sedat Ulkatan, Ana Maria Jaramillo, Maria J Téllez, Robert R Goodman, Vedran Deletis
OBJECTIVE: To explore the feasibility of eliciting the brainstem H reflex in the masseter muscle in patients under general anesthesia. METHODS: We electrically stimulated the masseteric nerve, a branch of the trigeminal nerve, and recorded ipsilateral masseteric and temporalis muscle responses. We tested eight patients who presented with trigeminal neuralgia; one patient had a temporal bone tumor and one patient had a brainstem arteriovenous malformation. All responses were elicited when patients were under general anesthesia and before the initiation of surgery...
November 5, 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/27875369/echocardiography-for-less-invasive-implantation-of-left-ventricular-assist-devices
#10
Harry Magunia, Christian Schlensak, David Schibilsky, Jan N Hilberath, Peter Rosenberger, Martina Nowak-Machen
New surgical techniques aim for less-invasive implantation of left ventricular assist devices (LVAD) via small surgical incision sites. Echocardiography plays an important role during patient selection and guidance of the procedure. The surgical incision site can be identified preoperatively by transthoracic echocardiography. Intraoperative identification of left ventricular apex, de-airing and monitoring heart function is performed by transesophageal echocardiography. This article highlights special echocardiographic considerations during less-invasive LVAD implantation surgeries...
November 21, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27871631/-benefit-of-general-anesthesia-monitored-by-bispectral-index-compared-with-monitoring-guided-only-by-clinical-parameters-systematic-review-and-meta-analysis
#11
Carlos Rogério Degrandi Oliveira, Wanderley Marques Bernardo, Victor Moisés Nunes
BACKGROUND: The bispectral index parameter is used to guide the titration of general anesthesia; however, many studies have shown conflicting results regarding the benefits of bispectral index monitoring. The objective of this systematic review with meta-analysis is to evaluate the clinical impact of monitoring with the bispectral index parameter. METHODS: The search for evidence in scientific information sources was conducted during December 2013 to January 2015, the following primary databases: Medline/PubMed, LILACS, Cochrane, CINAHL, Ovid, SCOPUS and TESES...
November 18, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27871520/cisatracurium-and-rocuronium-associated-residual-neuromuscular-dysfunction-under-intraoperative-neuromuscular-monitoring-and-postoperative-neostigmine-reversal-a-single-blind-randomized-trial
#12
Paolo Feltracco, Tommaso Tonetti, Stefania Barbieri, Anna Chiara Frigo, Carlo Ori
BACKGROUND: Postoperative residual neuromuscular blockade (RNMB) is a common complication in the postanesthesia care unit (PACU), but also one of the most controversial issues. Many studies and trials demonstrated that some methods and techniques can reduce the incidence and the extent of the phenomenon. STUDY OBJECTIVE: To determine the incidence of RNMB in the PACU at standardized times after extubation with the implementation of a protocol of careful neuromuscular blockade management...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871494/current-surgical-management-of-carotid-body-tumors
#13
Victor J Davila, James M Chang, William M Stone, Richard J Fowl, Thomas C Bower, Michael L Hinni, Samuel R Money
BACKGROUND: Carotid body tumors (CBTs) are rare. Management guidelines may include genetic testing for succinate dehydrogenase (SDH) mutations. We performed an institutional review of the surgical management of CBT. METHODS: A retrospective analysis (1994-2015) of CBT excisions at our institution was performed. Data obtained included demographics, genetic testing (if performed), intraoperative details, postoperative morbidity, and long-term outcomes. Data from the first CBT excision were included in patients with bilateral tumors...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27870825/evaluation-of-pediatric-liver-transplantation-related-artery-complications-using-intra-operative-multi-parameter-ultrasonography
#14
Xiuyun Ren, Junhui Guan, Nong Gao, Hong Niu, Jie Tang
BACKGROUND This article discusses the value of using multi-parameter evaluation of intra-operative ultrasonography in evaluating pediatric liver transplantation-related arterial complications. MATERIAL AND METHODS Sixty-eight children receiving a liver transplant underwent intraoperative ultrasonography for monitoring of artery hemodynamics. The ultrasonic measurement parameters included the diameters of the hepatic artery (HA) of the donor and anastomotic stoma, peak systolic velocity (PSV), resistance index (RI), acceleration time (SAT), and blood flow volume...
November 21, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27867862/intermittent-neural-monitoring-of-the-recurrent-laryngeal-nerve-in-surgery-for-recurrent-goiter
#15
REVIEW
Beata Wojtczak, Marcin Barczyński
Reoperative thyroid surgery is still challenging even for skilled surgeons, and is associated with a higher incidence of complications, such as hypoparathyroidism and recurrent laryngeal nerve (RLN) palsy. Displacement of the RLN, scar tissue from previous neck surgery and difficulty in maintaining good hemostasis are risk factors in reoperations. The prevalence of RLN injury in reoperative thyroid surgery ranges as high as 12.5% for transient injury and up to 3.8% for permanent injury. Bilateral paresis can also occur during reoperations, and is a dangerous complication influencing the quality of life, sometimes requiring tracheostomy...
October 2016: Gland Surgery
https://www.readbyqxmd.com/read/27867861/intraoperative-neural-monitoring-in-thyroid-surgery-lessons-learned-from-animal-studies
#16
REVIEW
Che-Wei Wu, Gregory W Randolph, I-Cheng Lu, Pi-Ying Chang, Yi-Ting Chen, Pao-Chu Hun, Yi-Chu Lin, Gianlorenzo Dionigi, Feng-Yu Chiang
Recurrent laryngeal nerve (RLN) injury remains a significant morbidity associated with thyroid and parathyroid surgery. In the past decade, surgeons have increasingly used intraoperative neural monitoring (IONM) as an adjunct technique for localizing and identifying the RLN, detecting RLN injury, and predicting the outcome of vocal cord function. In recent years, many animal studies have investigated common pitfalls and new applications of IONM. For example, the use of IONM technology in animal models has proven valuable in studies of the electrophysiology of RLN injury...
October 2016: Gland Surgery
https://www.readbyqxmd.com/read/27866865/accelerated-partial-breast-irradiation-executive-summary-for-the-update-of-an-astro-evidence-based-consensus-statement
#17
Candace Correa, Eleanor E Harris, Maria Cristina Leonardi, Benjamin D Smith, Alphonse G Taghian, Alastair M Thompson, Julia White, Jay R Harris
PURPOSE: To update the accelerated partial breast irradiation Consensus Statement published in 2009 and provide guidance on use of intraoperative radiation therapy (IORT) for partial breast irradiation in early-stage breast cancer, based on published evidence complemented by expert opinion. METHODS AND MATERIALS: A systematic PubMed search using the same terms as the original Consensus Statement yielded 419 articles; 44 articles were selected. The authors synthesized the published evidence and, through a series of conference calls and e-mails, reached consensus regarding the recommendations...
September 17, 2016: Practical Radiation Oncology
https://www.readbyqxmd.com/read/27863787/characterizing-the-operative-findings-and-utility-of-intraoperative-parathyroid-hormone-iopth-monitoring-in-patients-with-normal-baseline-iopth-and-normohormonal-primary-hyperparathyroidism
#18
Gina Trinh, Salem I Noureldine, Jonathon O Russell, Nishant Agrawal, Michael Lopez, Jason D Prescott, Martha A Zeiger, Ralph P Tufano
BACKGROUND: During parathyroidectomy with intraoperative parathyroid hormone monitoring, the successful removal of a hypersecreting gland(s) resulting in normocalcemia is indicated by a >50% decrease in intraoperative parathyroid hormone level, typically into the normal range. Some patients, however, will have baseline parathyroid hormone levels within the normal range. We sought to determine the utility of intraoperative parathyroid hormone testing in these patients. METHODS: We retrospectively studied all patients who underwent parathyroidectomy for primary hyperparathyroidism at our institution over a 10-year period...
November 15, 2016: Surgery
https://www.readbyqxmd.com/read/27862979/cerebral-tissue-oxygenation-index-and-lactate-at-24-hours-postoperative-predict-survival-and-neurodevelopmental-outcome-after-neonatal-cardiac-surgery
#19
Safwat A Aly, David Zurakowski, Penny Glass, Kami Skurow-Todd, Richard A Jonas, Mary T Donofrio
IMPORTANCE: There are no well-established noninvasive biomarkers for identifying patients at risk for poor outcome after surgery for congenital heart disease. Few studies have assessed prognostic accuracy of cerebral tissue oxygenation index (cTOI) measured by near infrared spectroscopy (NIRS). OBJECTIVE: To assess the utility of noninvasive NIRS monitoring as a predictor of outcomes after neonatal cardiac surgery through measurement of cTOI. To examine the utility of noninvasive NIRS monitoring in combination with lactate concentration and inotropic score in prediction of outcomes after neonatal cardiac surgery...
November 10, 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27861939/changes-in-electromyographic-amplitudes-but-not-latencies-occur-with-endotracheal-tube-malpositioning-during-intraoperative-monitoring-for-thyroid-surgery-implications-for-guidelines
#20
Samuel R Barber, Whitney Liddy, Natalia Kyriazidis, Matteo Cinquepalmi, Brian M Lin, Rahul Modi, Stephanie Patricio, Dipti Kamani, Carlo Belotti, Sadhana Mahamad, Bradley Lawson, Gregory W Randolph
OBJECTIVES/HYPOTHESIS: During intraoperative neural monitoring (IONM) in thyroid and parathyroid surgery, endotracheal (ET) tube migration can result in a decrease in vocalis electromyographic (EMG) amplitude without a concordant latency elevation during stimulation of the recurrent laryngeal nerve (RLN). STUDY DESIGN: Retrospective review. METHODS: Data were reviewed retrospectively for thyroid and parathyroid surgery patients with IONM of the laryngeal nerves from January 2015 to December 2015...
November 16, 2016: Laryngoscope
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