Intraoperative Posterior Cricoarytenoid Muscle Electromyography May Predict Vocal Cord Function Prognosis after Loss of Signal during Thyroidectomy
Purpose Intraoperative posterior cricoarytenoid muscle (PCAM) electromyography (EMG) may be useful for predicting postoperative vocal cord function (VCF) and prognosis of vocal cord palsy (VCP) in patients with intraoperative loss of signal (LOS). Materials and Methods Thirty out of 395 patients hav...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2021-06-01
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| Series: | Journal of Investigative Surgery |
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| Online Access: | http://dx.doi.org/10.1080/08941939.2021.1942338 |
| _version_ | 1797684469516206080 |
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| author | Nurcihan Aygun Adnan Isgor Mehmet Uludag |
| author_facet | Nurcihan Aygun Adnan Isgor Mehmet Uludag |
| author_sort | Nurcihan Aygun |
| collection | DOAJ |
| description | Purpose Intraoperative posterior cricoarytenoid muscle (PCAM) electromyography (EMG) may be useful for predicting postoperative vocal cord function (VCF) and prognosis of vocal cord palsy (VCP) in patients with intraoperative loss of signal (LOS). Materials and Methods Thirty out of 395 patients having LOS detected by intraoperative neural monitoring (IONM), were applied intraoperative PCAM EMG. Results VCP was present in all Type 1 injury RLNs (16) (100%) and in 8 (57%) of 14 RLNs with Type 2 injury (p = 0.005). 14 out of 30 LOS patients (47%) had positive PCAM EMG amplitudes. The sensitivity, specificity, positive and negative predictive values and accuracy rates for predicting postoperative VCP via PCAM EMG, were calculated as 66.7%, 100%,100%, 42.86% and 73.33%. The negative PCAM EMG was related to VCP in both Type 1 and Type 2 LOS. VCP recovery time of Type 1 LOS patients was significantly longer than that of Type 2 LOS patients (p = 0.009). In Type 2 LOS, VCP recovery time was significantly longer in negative PCAM EMG patients compared to positive PCAM EMG patients (p = 0.046). Conclusion Negative PCAM EMG is associated with the postoperative VCP. Type 1 injury results in VCP regardless of PCAM EMG results, and VCF recovers after a longer period compared to Type 2 LOS. In Type 2 LOS, positive PCAM EMG may result in VCP by 40%. However, the presence of negative PCAM EMG is related to the postoperative VCP in all patients and the recovery time is longer compared to positive PCAM EMG patients. |
| first_indexed | 2024-03-12T00:30:07Z |
| format | Article |
| id | doaj.art-5fe0fea343a843618f8ab749a0ce1d21 |
| institution | Directory Open Access Journal |
| issn | 0894-1939 1521-0553 |
| language | English |
| last_indexed | 2024-03-12T00:30:07Z |
| publishDate | 2021-06-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Investigative Surgery |
| spelling | doaj.art-5fe0fea343a843618f8ab749a0ce1d212023-09-15T10:21:28ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532021-06-0135476877510.1080/08941939.2021.19423381942338Intraoperative Posterior Cricoarytenoid Muscle Electromyography May Predict Vocal Cord Function Prognosis after Loss of Signal during ThyroidectomyNurcihan Aygun0Adnan Isgor1Mehmet Uludag2Department of General Surgery, University of Health Sciences, Sisli Hamidiye Etfal Training and Research HospitalFaculty of Medicine, Department of General Surgery, Bahcesehir UniversityDepartment of General Surgery, University of Health Sciences, Sisli Hamidiye Etfal Training and Research HospitalPurpose Intraoperative posterior cricoarytenoid muscle (PCAM) electromyography (EMG) may be useful for predicting postoperative vocal cord function (VCF) and prognosis of vocal cord palsy (VCP) in patients with intraoperative loss of signal (LOS). Materials and Methods Thirty out of 395 patients having LOS detected by intraoperative neural monitoring (IONM), were applied intraoperative PCAM EMG. Results VCP was present in all Type 1 injury RLNs (16) (100%) and in 8 (57%) of 14 RLNs with Type 2 injury (p = 0.005). 14 out of 30 LOS patients (47%) had positive PCAM EMG amplitudes. The sensitivity, specificity, positive and negative predictive values and accuracy rates for predicting postoperative VCP via PCAM EMG, were calculated as 66.7%, 100%,100%, 42.86% and 73.33%. The negative PCAM EMG was related to VCP in both Type 1 and Type 2 LOS. VCP recovery time of Type 1 LOS patients was significantly longer than that of Type 2 LOS patients (p = 0.009). In Type 2 LOS, VCP recovery time was significantly longer in negative PCAM EMG patients compared to positive PCAM EMG patients (p = 0.046). Conclusion Negative PCAM EMG is associated with the postoperative VCP. Type 1 injury results in VCP regardless of PCAM EMG results, and VCF recovers after a longer period compared to Type 2 LOS. In Type 2 LOS, positive PCAM EMG may result in VCP by 40%. However, the presence of negative PCAM EMG is related to the postoperative VCP in all patients and the recovery time is longer compared to positive PCAM EMG patients.http://dx.doi.org/10.1080/08941939.2021.1942338thyroidectomyposterior cricoarytenoid muscle electromyographyloss of signalvocal cord paralysisrecurrent laryngeal nerveintraoperative neuromonitorisation |
| spellingShingle | Nurcihan Aygun Adnan Isgor Mehmet Uludag Intraoperative Posterior Cricoarytenoid Muscle Electromyography May Predict Vocal Cord Function Prognosis after Loss of Signal during Thyroidectomy Journal of Investigative Surgery thyroidectomy posterior cricoarytenoid muscle electromyography loss of signal vocal cord paralysis recurrent laryngeal nerve intraoperative neuromonitorisation |
| title | Intraoperative Posterior Cricoarytenoid Muscle Electromyography May Predict Vocal Cord Function Prognosis after Loss of Signal during Thyroidectomy |
| title_full | Intraoperative Posterior Cricoarytenoid Muscle Electromyography May Predict Vocal Cord Function Prognosis after Loss of Signal during Thyroidectomy |
| title_fullStr | Intraoperative Posterior Cricoarytenoid Muscle Electromyography May Predict Vocal Cord Function Prognosis after Loss of Signal during Thyroidectomy |
| title_full_unstemmed | Intraoperative Posterior Cricoarytenoid Muscle Electromyography May Predict Vocal Cord Function Prognosis after Loss of Signal during Thyroidectomy |
| title_short | Intraoperative Posterior Cricoarytenoid Muscle Electromyography May Predict Vocal Cord Function Prognosis after Loss of Signal during Thyroidectomy |
| title_sort | intraoperative posterior cricoarytenoid muscle electromyography may predict vocal cord function prognosis after loss of signal during thyroidectomy |
| topic | thyroidectomy posterior cricoarytenoid muscle electromyography loss of signal vocal cord paralysis recurrent laryngeal nerve intraoperative neuromonitorisation |
| url | http://dx.doi.org/10.1080/08941939.2021.1942338 |
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