Kaan Balcı, Yiğit Türk, Murat Özdemir, Paulina Kuczma, Christophe Tresallet, Che-Wei Wu, Tzu-Yen Huang, Adi Syazni Muhammed, Rohaizak Muhammad, Shahrun Niza Bin Abdullah Suhaimi, Nani Harlina, Matija Buzejic, Vladan Zivaljevic, Milan Jovanovic, Özer Makay
{"title":"甲状腺软骨针电极在甲状腺手术术中神经监测中的应用:一项多中心回顾性研究。","authors":"Kaan Balcı, Yiğit Türk, Murat Özdemir, Paulina Kuczma, Christophe Tresallet, Che-Wei Wu, Tzu-Yen Huang, Adi Syazni Muhammed, Rohaizak Muhammad, Shahrun Niza Bin Abdullah Suhaimi, Nani Harlina, Matija Buzejic, Vladan Zivaljevic, Milan Jovanovic, Özer Makay","doi":"10.1007/s13304-025-02178-1","DOIUrl":null,"url":null,"abstract":"<p><p>In previous studies, the use of thyroid cartilage needle electrodes (TCN) was defined as an inexpensive method for intra-operative nerve monitoring (IONM) in thyroid surgery. This multi-center retrospective study aims to determine the effectiveness and reliability of TCN in thyroid surgery. Patients operated on between January 2018 and August 2023 from five centers were included in this study. Demographic data, indications, type of surgery, IONM recording system, pre-post-resection vagus nerve (V1-V2), pre-post-resection recurrent laryngeal nerve (R1-R2) amplitudes and latency values, type of loss of signal (LOS), adverse event (AE), intra-operative injury mechanism, and post-operative vocal cord examination (VCE) were evaluated. Patients with abnormal preoperative vocal cord examination were excluded. A total of 2105 patients (3772 nerves at risk) were included [1626 (77%) female, 479 (23%) male]; within this study, 1112 patients (53%) received a diagnosis of malignancy, while 993 (47%) were diagnosed with benign conditions. The mean initial vagus amplitude was 1093.74 µV (± 861.39). LOS occurred in 63 patients [Type 1 (84%), Type 2 (16%)] and AE in 36. No false-positive LOS occurred. Forty-six (87%) of LOS type 1 patients and nine (90%) of LOS type 2 patients had vocal cord palsy (VCP) during VCE (p < 0.05). In AE patients, there were only two (5.5%) patients who had vocal cord palsy during VCE (p < 0.05). VCP occurred in 57(2.7%) patients, with 9 (0.42%) remaining permanent. TCN is an inexpensive and feasible alternative to endotracheal tube electrodes and a system with satisfying amplitudes. It can also precisely predict post-operative vocal cord functions.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The use of thyroid cartilage needle electrodes during intra-operative nerve monitoring in thyroid surgery: A multi-center retrospective study.\",\"authors\":\"Kaan Balcı, Yiğit Türk, Murat Özdemir, Paulina Kuczma, Christophe Tresallet, Che-Wei Wu, Tzu-Yen Huang, Adi Syazni Muhammed, Rohaizak Muhammad, Shahrun Niza Bin Abdullah Suhaimi, Nani Harlina, Matija Buzejic, Vladan Zivaljevic, Milan Jovanovic, Özer Makay\",\"doi\":\"10.1007/s13304-025-02178-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>In previous studies, the use of thyroid cartilage needle electrodes (TCN) was defined as an inexpensive method for intra-operative nerve monitoring (IONM) in thyroid surgery. 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The use of thyroid cartilage needle electrodes during intra-operative nerve monitoring in thyroid surgery: A multi-center retrospective study.
In previous studies, the use of thyroid cartilage needle electrodes (TCN) was defined as an inexpensive method for intra-operative nerve monitoring (IONM) in thyroid surgery. This multi-center retrospective study aims to determine the effectiveness and reliability of TCN in thyroid surgery. Patients operated on between January 2018 and August 2023 from five centers were included in this study. Demographic data, indications, type of surgery, IONM recording system, pre-post-resection vagus nerve (V1-V2), pre-post-resection recurrent laryngeal nerve (R1-R2) amplitudes and latency values, type of loss of signal (LOS), adverse event (AE), intra-operative injury mechanism, and post-operative vocal cord examination (VCE) were evaluated. Patients with abnormal preoperative vocal cord examination were excluded. A total of 2105 patients (3772 nerves at risk) were included [1626 (77%) female, 479 (23%) male]; within this study, 1112 patients (53%) received a diagnosis of malignancy, while 993 (47%) were diagnosed with benign conditions. The mean initial vagus amplitude was 1093.74 µV (± 861.39). LOS occurred in 63 patients [Type 1 (84%), Type 2 (16%)] and AE in 36. No false-positive LOS occurred. Forty-six (87%) of LOS type 1 patients and nine (90%) of LOS type 2 patients had vocal cord palsy (VCP) during VCE (p < 0.05). In AE patients, there were only two (5.5%) patients who had vocal cord palsy during VCE (p < 0.05). VCP occurred in 57(2.7%) patients, with 9 (0.42%) remaining permanent. TCN is an inexpensive and feasible alternative to endotracheal tube electrodes and a system with satisfying amplitudes. It can also precisely predict post-operative vocal cord functions.
期刊介绍:
Updates in Surgery (UPIS) has been founded in 2010 as the official journal of the Italian Society of Surgery. It’s an international, English-language, peer-reviewed journal dedicated to the surgical sciences. Its main goal is to offer a valuable update on the most recent developments of those surgical techniques that are rapidly evolving, forcing the community of surgeons to a rigorous debate and a continuous refinement of standards of care. In this respect position papers on the mostly debated surgical approaches and accreditation criteria have been published and are welcome for the future.
Beside its focus on general surgery, the journal draws particular attention to cutting edge topics and emerging surgical fields that are publishing in monothematic issues guest edited by well-known experts.
Updates in Surgery has been considering various types of papers: editorials, comprehensive reviews, original studies and technical notes related to specific surgical procedures and techniques on liver, colorectal, gastric, pancreatic, robotic and bariatric surgery.