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우승훈(Seung Hoon Woo) 대한신경모니터링학회 2022 Journal of Neuromonitoring & Neurophysiology Vol.2 No.2
Over the past decade, the use of intraoperative neuro monitoring (IONM) in thyroid surgery has been widely accepted by surgeons as a useful technique for improving laryngeal neurological identification and speech results, promoting neurophysiological research, educating and training surgeons. Providing patients with information about IONM is a good practice to promote the efficient use of IONM resources and is essential for effective joint decision making between patients and surgeons. The preoperative plan and patient consent process are important for all patients who undergo thyroid surgery. The purpose of this paper is to summarize general and specific considerations, along with pre-consent criteria for using IONM to support surgeons and patients during prethyroid surgery and shared decision making processes.
기관 암 수술 중 바늘 전극을 활용한 반회후두신경 모니터링 1예
김영근(Young Gun Kim),박헌수(Heon Soo Park),이동근(Dong Kun Lee) 대한신경모니터링학회 2022 Journal of Neuromonitoring & Neurophysiology Vol.2 No.2
Paralysis of the recurrent laryngeal nerve is one of the important complications that can occur after thyroidectomy. When unilateral paralysis of the recurrent laryngeal nerve occurs, the patient complains of hoarseness and aspiration. Bilateral paralysis of the recurrent laryngeal nerve may cause upper airway obstruction, which may lead to respiratory difficulties. We report a case of a case of 50-year-old man diagnosed with trachea cancer who had primary resection and end to end anastomosis surgery with recurrent laryngeal nerve monitoring using needle electrodes, along with a review of the literature.
갑상선 수술에서 수술중신경계감시를 위한 전기진단검사의 기초
민지홍(Ji Hong Min) 대한신경모니터링학회 2022 Journal of Neuromonitoring & Neurophysiology Vol.2 No.2
Intraoperative neurophysiological monitoring (IONM) is a method of conducting neurophysiological examinations to prevent and minimize surgery complications by detecting neurological damage that may occur during surgery at an early stage by continuously monitoring and evaluating the function of the nervous system. IONM includes accurate interpretation of abnormal findings and appropriate actions by reflecting the overall procedure of the operation and examination of the correct method. Therefore, for accurate and effective IONM, it is important to perform it based on a sufficient understanding of the anatomical structure of nerves and neurophysiology.
지용배(Yong Bae Ji) 대한신경모니터링학회 2022 Journal of Neuromonitoring & Neurophysiology Vol.2 No.2
Intraoperative nerve monitoring (IONM) provides dynamic neural information and is recommended for high-risk thyroid surgery. If RLN is severely injured during the operation, most nerve fibers do not transmit nerve impulse and substantial decrease of EMG amplitude or loss of signal (LOS) will occur. However, surgeon should differentiate the true LOS from false LOS, because it can be false due to various reason. If LOS is true, the decision to perform contralateral surgery to prevent bilateral vocal cord paralysis should be prudent. The updated causes, algorithm, and management of LOS during IONM and potential benefit of staged thyroidectomy are reviewed and summarized.
이진춘(Jin-Choon Lee),성의숙(Eui-Suk Sung) 대한신경모니터링학회 2022 Journal of Neuromonitoring & Neurophysiology Vol.2 No.2
Vocal fold paralysis can occur for various reasons, and vocal fold paralysis treatment is important to improve the quality of life and secure airway according to voice. There are several methods of unilateral and bilateral vocal fold paralysis; voice therapy, injection laryngoplasty, laryngeal framework surgery, reinnervation procedures, tracheostomy, arytenoidectomy, cordotomy, cordectomy, and laterofixation of vocal cord. This review paper aims to discuss the treatment principles of unilateral and bilateral vocal fold paralysis.
신세포암종의 경부 림프절 전이 절제술 중 미주신경에 대한 수술 중 신경모니터링 증례 보고
Hyoung Shin Lee(Hyoung Shin Lee),Yeongjoon Kim(Yeongjoon Kim),Kang Dae Lee(Kang Dae Lee) 대한신경모니터링학회 2022 Journal of Neuromonitoring & Neurophysiology Vol.2 No.2
Intraoperative neuromonitoring (IONM) of recurrent laryngeal nerve has been widely applied worldwide. However, IONM of vagus nerve during lateral neck surgery has been rarely reported. In this case report, we introduce the application of IONM of vagus nerve during dissection of a metastatic lymph node of renal cell carcinoma of left level IV located deep to the vagus nerve.
갑상선 수술 중 신경 손상을 피하기 위한 수술 중 신경 모니터링의 활용
지용배(Yong Bae Ji) 대한신경모니터링학회 2021 Journal of Neuromonitoring & Neurophysiology Vol.1 No.1
Traditionally, visual identification of the nerve is the gold standard to avoid injury. Intraoperative neural monitoring (IONM) has been world-widely popularized in thyroid and parathyroid surgery because it helps identify the nerve. Despite the increasing use of IONM, there is a controversy that IONM can reduce recurrent laryngeal nerve (RLN) injury. It may be derived from the lack of uniformity in the application of and results from nerve monitoring between surgeons. IONM can not only be used to check the nerves, but it can also provide a lot of information to the surgeon. By using this information properly, the function of nerves can be monitored sensitively during surgery, and through this, a surgeon can be relatively freed from nerve damage. Proper use of IONM can improve the quality of neural monitoring and drive surgeons to best practices. In this paper, consistent and useful use of IONM has been described.
Optimal anesthesia protocols for successful intraoperative neuromonitoring during thyroid surgery
Jiwon Lee(Jiwon Lee),Jung-Man Lee(Jung-Man Lee),Young Jun Chai(Young Jun Chai) 대한신경모니터링학회 2022 Journal of Neuromonitoring & Neurophysiology Vol.2 No.2
There are several factors related to anesthesia that are required for successful intraoperative neuromonitoring (IONM) during thyroid and parathyroid surgery, including proper placement of endotracheal tube, adequate neuromuscular blockade, use of appropriate neuromuscular blockade reversal agent, and pain management. In this review, we summarize the anesthesia issues related to IONM during thyroid and parathyroid surgery.