재발성 갑상선 수술에서 근전도 튜브를 이용한 신경감시의 유용성

김성운; 김재욱; 박재홍; 오천환; 장혁순; 고윤우; 이승원

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자료유형: 학술저널

저자정보: 김성운 김재욱 박재홍 오천환 장혁순 고윤우 이승원

저널정보: 대한이비인후과학회 대한이비인후-두경부외과학회지 대한이비인후과학회지 두경부외과학 제55권 제4호

발행연도: 2012.1

수록면: 229 - 233 (5page)

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Background and Objectives Recurrent laryngeal nerve (RLN) injury is a potentially debilitating complication of thyroid surgery. In re-operative thyroid surgery, the risk of vocal fold paralysis increases significantly. This study evaluated the efficiency of intraoperative RLN monitoring using an electromyography (EMG) tube in an re-operative thyroid surgery and the prediction of postoperative neural function from the relationship between the intraoperative neuromonitoring response and postoperative vocal fold function. Subjects and Method Sixty-nine patients undergoing reoperative thyroid surgery were divided into two groups: 37 patients underwent reoperative thyroid surgery with intraoperative neuromonitoring (EMG group) and 32 patients underwent reoperative thyroid surgery without intraoperative neuromonitoring (no EMG group). The prevalence of transient and permanent vocal fold paralysis was evaluated in each group. In addition, the sensitivity, specificity, and negative and positive predictive values of intraoperative neuromonitoring were evaluated. Results Transient and permanent vocal fold paralysis occurred in 8.1% (3/37) and 2.7% (1/37) of the EMG group and 12.5% (4/32) and 6.3% (2/32) of the no EMG group, respectively. The negative and positive predictive values of intraoperative neuromonitoring using an EMG tube in predicting postoperative vocal fold function were 100% and 57.1%, respectively. Conclusion Although the differences were not significant, intraoperative neuromonitoring using the EMG tube resulted in shorter operating time, and less transient and permanent vocal fold paralysis during reoperative thyroid surgery. Intraoperative neuromonitoring using an EMG tube for reoperative thyroid surgery may be useful for preserving the postoperative vocal fold function.

#Reoperative thyroid surgery #Intraoperative neuromonitoring #Recurrent laryngeal nerve

참고문헌 (16)

참고문헌 신청

Angelos P / 2009 / / Surg Clin North Am 89 (5) : 1157 ~ 1169

Atallah I / 2009 / Role of intraoperative neuromonitoring of the recurrent laryngeal nerve in high-risk thyroid surgery / J Otolaryngol Head Neck Surg 38 (6) : 613 ~ 618

Barczy?ki M / 2009 / Randomized clinical trial of visualization versus neuromonitoring of recurrent laryngeal nerves during thyroidectomy / Br J Surg 96 (3) : 240 ~ 246

Chan WF / 2006 / Pitfalls of intraoperative neuromonitoring for predicting postoperative recurrent laryngeal nerve function during thyroidectomy / World J Surg 30 (5) : 806 ~

Chan WF / 2006 / The role of intraoperative neuromonitoring of recurrent laryngeal nerve during thyroidectomy: a comparative study on 1000 nerves at risk / Surgery 140 (6) :