Pre-Prototype Stimulating and Recording Endotracheal Tube for Continuous Monitoring of the Recurrent Laryngeal Nerve During Thyroid Surgery
Introduction Continuous intraoperative neural monitoring (C-IONM) is a promising technology used to decrease recurrent laryngeal nerve (RLN) damage during thyroid surgery. However, C-IONM use is limited due to its challenging application. C-IONM requires dissection of the carotid sheath and placemen...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2021-08-01
|
| Series: | Journal of Investigative Surgery |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/08941939.2020.1734693 |
| _version_ | 1797684645001691136 |
|---|---|
| author | Daqi Zhang Tie Wang Yishen Zhao Hui Sun Antonella Pino Hoon Yub Kim Gianlorenzo Dionigi |
| author_facet | Daqi Zhang Tie Wang Yishen Zhao Hui Sun Antonella Pino Hoon Yub Kim Gianlorenzo Dionigi |
| author_sort | Daqi Zhang |
| collection | DOAJ |
| description | Introduction Continuous intraoperative neural monitoring (C-IONM) is a promising technology used to decrease recurrent laryngeal nerve (RLN) damage during thyroid surgery. However, C-IONM use is limited due to its challenging application. C-IONM requires dissection of the carotid sheath and placement of an electrode around the vagus nerve (VN). In our study, we simultaneously stimulated and monitored the proximal RLN trans-tracheally using surface electrodes that were positioned solely on the endotracheal tube. Methods We described the design, implementation, and testing of a pre-prototype, combined stimulating and recording endotracheal tube (SRET) that continually delivered current from tube edge, and tested the function of the RLN at the vocal cords (VC). The SRET was tested in vivo on 10 RLNs using 5 pigs as animal models. Results The SRET was capable of the following, delivery of continuous trans-tracheal stimulation to the proximal RLN, continuous trans-tracheal stimulation-induced VC movement, and standard ipsilateral RLN biphasic waveforms with latency and amplitude; and recording evoked responses were recorded in the ipsilateral RLN. Conclusion The pre-prototype SRET represents a possible advancement in technology because it simplified the C-IONM. Thus, the SRET provides a minimally invasive, alternative application to the C-IONM vagal nerve cuff electrodes. |
| first_indexed | 2024-03-12T00:33:41Z |
| format | Article |
| id | doaj.art-f55a1d622cef4f9795fdc20f7cbd081e |
| institution | Directory Open Access Journal |
| issn | 0894-1939 1521-0553 |
| language | English |
| last_indexed | 2024-03-12T00:33:41Z |
| publishDate | 2021-08-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Investigative Surgery |
| spelling | doaj.art-f55a1d622cef4f9795fdc20f7cbd081e2023-09-15T10:07:32ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532021-08-013491033104310.1080/08941939.2020.17346931734693Pre-Prototype Stimulating and Recording Endotracheal Tube for Continuous Monitoring of the Recurrent Laryngeal Nerve During Thyroid SurgeryDaqi Zhang0Tie Wang1Yishen Zhao2Hui Sun3Antonella Pino4Hoon Yub Kim5Gianlorenzo Dionigi6Division of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational MedicineDivision of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational MedicineDivision of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational MedicineDivision of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational MedicineDivision for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood ‘‘G. Barresi’’, University Hospital G. Martino, University of MessinaDepartment of Surgery, Division of Breast and Endocrine Surgery, Minimally Invasive Surgery and Robotic Surgery Center, KUMC Thyroid Center Korea University, Anam HospitalDivision for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood ‘‘G. Barresi’’, University Hospital G. Martino, University of MessinaIntroduction Continuous intraoperative neural monitoring (C-IONM) is a promising technology used to decrease recurrent laryngeal nerve (RLN) damage during thyroid surgery. However, C-IONM use is limited due to its challenging application. C-IONM requires dissection of the carotid sheath and placement of an electrode around the vagus nerve (VN). In our study, we simultaneously stimulated and monitored the proximal RLN trans-tracheally using surface electrodes that were positioned solely on the endotracheal tube. Methods We described the design, implementation, and testing of a pre-prototype, combined stimulating and recording endotracheal tube (SRET) that continually delivered current from tube edge, and tested the function of the RLN at the vocal cords (VC). The SRET was tested in vivo on 10 RLNs using 5 pigs as animal models. Results The SRET was capable of the following, delivery of continuous trans-tracheal stimulation to the proximal RLN, continuous trans-tracheal stimulation-induced VC movement, and standard ipsilateral RLN biphasic waveforms with latency and amplitude; and recording evoked responses were recorded in the ipsilateral RLN. Conclusion The pre-prototype SRET represents a possible advancement in technology because it simplified the C-IONM. Thus, the SRET provides a minimally invasive, alternative application to the C-IONM vagal nerve cuff electrodes.http://dx.doi.org/10.1080/08941939.2020.1734693pre-prototypenerve monitoringcontinuous nerve monitoringrecurrent laryngeal nervethyroid surgerystimulation and recording endotracheal tubeemgamplitudelatencywaveformmorbidity |
| spellingShingle | Daqi Zhang Tie Wang Yishen Zhao Hui Sun Antonella Pino Hoon Yub Kim Gianlorenzo Dionigi Pre-Prototype Stimulating and Recording Endotracheal Tube for Continuous Monitoring of the Recurrent Laryngeal Nerve During Thyroid Surgery Journal of Investigative Surgery pre-prototype nerve monitoring continuous nerve monitoring recurrent laryngeal nerve thyroid surgery stimulation and recording endotracheal tube emg amplitude latency waveform morbidity |
| title | Pre-Prototype Stimulating and Recording Endotracheal Tube for Continuous Monitoring of the Recurrent Laryngeal Nerve During Thyroid Surgery |
| title_full | Pre-Prototype Stimulating and Recording Endotracheal Tube for Continuous Monitoring of the Recurrent Laryngeal Nerve During Thyroid Surgery |
| title_fullStr | Pre-Prototype Stimulating and Recording Endotracheal Tube for Continuous Monitoring of the Recurrent Laryngeal Nerve During Thyroid Surgery |
| title_full_unstemmed | Pre-Prototype Stimulating and Recording Endotracheal Tube for Continuous Monitoring of the Recurrent Laryngeal Nerve During Thyroid Surgery |
| title_short | Pre-Prototype Stimulating and Recording Endotracheal Tube for Continuous Monitoring of the Recurrent Laryngeal Nerve During Thyroid Surgery |
| title_sort | pre prototype stimulating and recording endotracheal tube for continuous monitoring of the recurrent laryngeal nerve during thyroid surgery |
| topic | pre-prototype nerve monitoring continuous nerve monitoring recurrent laryngeal nerve thyroid surgery stimulation and recording endotracheal tube emg amplitude latency waveform morbidity |
| url | http://dx.doi.org/10.1080/08941939.2020.1734693 |
| work_keys_str_mv | AT daqizhang preprototypestimulatingandrecordingendotrachealtubeforcontinuousmonitoringoftherecurrentlaryngealnerveduringthyroidsurgery AT tiewang preprototypestimulatingandrecordingendotrachealtubeforcontinuousmonitoringoftherecurrentlaryngealnerveduringthyroidsurgery AT yishenzhao preprototypestimulatingandrecordingendotrachealtubeforcontinuousmonitoringoftherecurrentlaryngealnerveduringthyroidsurgery AT huisun preprototypestimulatingandrecordingendotrachealtubeforcontinuousmonitoringoftherecurrentlaryngealnerveduringthyroidsurgery AT antonellapino preprototypestimulatingandrecordingendotrachealtubeforcontinuousmonitoringoftherecurrentlaryngealnerveduringthyroidsurgery AT hoonyubkim preprototypestimulatingandrecordingendotrachealtubeforcontinuousmonitoringoftherecurrentlaryngealnerveduringthyroidsurgery AT gianlorenzodionigi preprototypestimulatingandrecordingendotrachealtubeforcontinuousmonitoringoftherecurrentlaryngealnerveduringthyroidsurgery |