Petar Stanković, Michael Bette, Robert Mandić, Stephan Hoch, Boris A Stuck, Thomas Wilhelm
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引用次数: 0
摘要
目的尽管双极烧灼术（BC）在腮腺手术中经常使用，但目前还没有数据表明在距离面神经（FN）多远的地方进行双极烧灼术是安全的：方法：在 16 只 Wistar 大鼠中使用术中连续神经监测仪（cIONM, NIM™ 3, Medtronic）测量损伤程度。cIONM 的振幅下降至少 50%（A50）或信号丢失（LOS）被定义为有害；BC 的功率范围为 20-60 W：BC≤30 W 不会导致 LOS（0/14 条神经）。当使用 35 W 时，A50 出现在距 FN 4 mm 处，5 条神经中有 1 条出现 LOS。功率为 40 至 60 W 的 BC 在距离 5 mm 的所有神经（12/12）中都显示出 LOS：结论：在距离 FN 3 mm 的范围内，可以安全地使用 30 W 的 BC。应避免使用 40 至 60 瓦的 BC，仅在距离 FN 6 毫米以上时使用：NA/动物研究。喉镜》，2024 年。
Safe distance from facial nerve for bipolar coagulation in parotid surgery-Animal study.
Objective: Currently no data exist on what distance from facial nerve (FN) it is safe to perform bipolar cautery (BC) in parotid surgery, although frequently performed.
Methods: The degree of damage was measured using continuous intraoperative neuromonitoring (cIONM, NIM™ 3, Medtronic) in 16 Wistar rats. Amplitude drop of at least 50% (A50) or a loss of signal (LOS) in the cIONM was defined as harmful; BC was performed in power range 20-60 W.
Results: BC ≤30 W did not cause LOS (0/14 nerves). When applying 35 W, A50 occurred at 4 mm from FN and LOS was noted in 1 of 5 nerves. BC at a power of 40 to 60 W demonstrated LOS in all nerves (12/12) at a 5 mm distance.
Conclusion: BC up to 30 W can be safely applied up to 3 mm distance from FN. 40 to 60 W should be avoided and used only at a distance of over 6 mm from FN.
Level of evidence: NA/animal study. Laryngoscope, 2024.
期刊介绍：
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects
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