Neuromonitoring

14,000,000 Leading Edge Experts on the ideXlab platform

Scan Science and Technology

Contact Leading Edge Experts & Companies

Scan Science and Technology

Contact Leading Edge Experts & Companies

The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform

Feng Yu Chiang - One of the best experts on this subject based on the ideXlab platform.

  • gastric acid secretion and gastrin release during continuous vagal Neuromonitoring in thyroid surgery
    Langenbeck's Archives of Surgery, 2017
    Co-Authors: Liu Xiaoli, Gregory W Randolph, Gianlorenzo Dionigi, Feng Yu Chiang, Chewei Wu, Wen Tian, Angkoon Anuwong, Matteo Lavazza
    Abstract:

    Purpose The vagus nerve (VN) has essential regulatory roles in the gastric acid secretion and gastrin release. Continuous intraoperative Neuromonitoring (CIONM) via VN stimulation is a promising technique in thyroid surgery because it potentially avoids injury to the recurrent laryngeal nerve. However, no studies have investigated changes in gastric acid secretion and gastrin release during CIONM.

  • prospective study of vocal fold function after loss of the Neuromonitoring signal in thyroid surgery the international neural monitoring study group s polt study
    Laryngoscope, 2016
    Co-Authors: Rick Schneider, Gregory W Randolph, Gianlorenzo Dionigi, Marcin Barczynski, Feng Yu Chiang, Frederic Triponez, Kyriakos Vamvakidis, Katrin Brauckhoff, Thomas J Musholt, Martin Almquist
    Abstract:

    Intraoperative Neuromonitoring identifies recurrent laryngeal nerve (RLN) injury and gives prognostic information regarding postoperative glottic function. Loss of the Neuromonitoring signal (LOS) signifies segmental type 1 or global type 2 RLN injury. This study aimed at identifying risk factors for RLN injury and determining vocal fold (VF) function initially and 6 months after definitive LOS.

  • loss of signal in recurrent nerve Neuromonitoring causes and management
    Gland surgery, 2015
    Co-Authors: Meihui Wang, Hsiuya Chen, Chengchien Chen, Huichun Chen, Piying Chang, Yichu Lin, Feng Yu Chiang
    Abstract:

    During recurrent laryngeal nerve (RLN) Neuromonitoring in thyroid surgery, laryngeal electromyography (EMG) amplitude may be correlated with the number of muscle fibers participating in the polarization and these might be correlated with the function of RLN. 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. True LOS at the end of an operation often indicates a postoperative fixed vocal cord, and the surgeon should consider the optimal contralateral surgery timing in patients with planned bilateral thyroid operation to avoid the disaster of bilateral vocal cord palsy. However, LOS recovery and false LOS may occur and may lead to an unnecessary 2 nd operation. Therefore, a reliable modality for intraoperative LOS evaluation and management would afford the surgeon real-time information that could help guide surgical procedure and planning. The updated causes, algorithm, and management of LOS during RLN Neuromonitoring are reviewed and summarized.

  • detecting and identifying nonrecurrent laryngeal nerve with the application of intraoperative Neuromonitoring during thyroid and parathyroid operation
    American Journal of Otolaryngology, 2012
    Co-Authors: Feng Yu Chiang, Chengjing Tsai, Pijung Hsiao, Kawo Lee
    Abstract:

    Abstract Purpose The nonrecurrent laryngeal nerve (NRLN) is a rare anatomical variant but associated with high risk of nerve injury during thyroid and parathyroid operations. Therefore, intraoperative detection and verification of NRLN are necessary. Method A total of 390 consecutive patients who underwent thyroid and parathyroid operations (310 RLNs dissected on the right side and 293 nerves on the left side) were enrolled. Electrically evoked electromyography was recorded from the vocalis muscles via an endotracheal tube with glottis surface recording electrodes. At an early stage of operation, vagal nerve was routinely stimulated at the level of inferior thyroid pole to ensure normal path of RLN. If there is a negative response from lower position but positive response from upper vagal stimulation, it indicates the occurrence of a NRLN, and we localize its separation point and path. Results Four right NRLNs (1.3%) without preoperative recognition were successfully detected at an early stage of operation. Three patients were operated on for thyroid disease, one for parathyroid adenoma and all were associated with right aberrant subclavian artery. All NRLNs were localized and identified precisely with intraoperative Neuromonitoring. Functional integrity of all nerves was confirmed by the intraoperative Neuromonitoring and postoperative laryngeal examination. Conclusions Vagal stimulation at the early stage of operation is a simple, useful, and reliable procedure to detect and identify the NRLN.

  • a comparative study between 1 and 2 effective doses of rocuronium for intraoperative Neuromonitoring during thyroid surgery
    Surgery, 2011
    Co-Authors: Cheng I Lu, Chengjing Tsai, Chewei Wu, Kwangi Cheng, Fuyuan Wang, Kuangyi Tseng, Feng Yu Chiang
    Abstract:

    Background The goal of this study was to explore an ideal application of rocuronium to enable adequate muscle relaxation for intubation without significantly affecting the evoked potentials measured by intraoperative Neuromonitoring during thyroid surgery. Methods A total of 80 patients were randomized to receive 1 (group 1, n = 40) or 2 (group 2, n = 40) effective doses (ED 95 ) of rocuronium to facilitate electromyographic (EMG) endotracheal tube insertion. Evoked potentials were obtained every 5 minutes by stimulating the vagus nerve between the time period of 30 and 70 minutes after administration of rocuronium. The magnitude of evoked potentials at each time point and the tracheal intubating conditions were compared between groups. Accelerometry (twitch [% TW]) was used to monitor the quantitative degree of neuromuscular transmission at the adductor pollicis muscle. Results At 30 minutes after administration of rocuronium, the rate of positive EMG response was 100% (40/40) in group 1 and 53% (21/40) in group 2 ( P P P P Conclusion A total of 1 ED 95 of rocuronium (0.3 mg/kg) is an optimal dose for intraoperative Neuromonitoring during thyroid surgery. Positive and high EMG signals were obtained in all patients at an early stage of operation, and satisfactory intubating conditions were achieved in most patients.

Henning Dralle - One of the best experts on this subject based on the ideXlab platform.

H Lang - One of the best experts on this subject based on the ideXlab platform.

  • intraoperative monitoring of bladder and internal anal sphincter innervation a predictor of erectile function following low anterior rectal resection for rectal cancer results of a prospective clinical study
    Digestive Surgery, 2013
    Co-Authors: W Kneist, D W Kauff, Peter Rubenwolf, Christian Thomas, C Hampel, H Lang
    Abstract:

    Background: The objective was to investigate whether two-dimensional intraoperative Neuromonitoring (IONM) of pelvic autonomic nerves has the potential to predict

  • online signal processing of internal anal sphincter activity during pelvic autonomic nerve stimulation a new method to improve the reliability of intra operative Neuromonitoring signals
    Colorectal Disease, 2011
    Co-Authors: D W Kauff, K P Koch, Axel Heimann, Klauspeter Hoffmann, H Lang, Karin Somerlik, W Kneist
    Abstract:

    Aim  Intra-operative Neuromonitoring is increasingly applied in several surgical disciplines and has been introduced to facilitate pelvic autonomic nerve preservation. Nevertheless, it has been considered a questionable tool for the minimization of risk, as the results are variable and might be misleading. The aim of the present experimental study was to develop an intra-operative Neuromonitoring system with improved reliability for monitoring pelvic autonomic nerve function. Method  Fifteen pigs underwent low anterior rectal resection with pelvic autonomic nerve preservation. Intra-operative Neuromonitoring was performed under autonomic nerve stimulation with observation of electromyographic signals of the internal anal sphincter and bladder manometry. As the internal anal sphincter frequency spectrum during stimulation was found to be mainly in the range of 5–20 Hz, intra-operative Neuromonitoring signals were postoperatively processed by implementation of matching band pass filters. Results  In 10 preliminary experiments, signal processing was performed offline in the postoperative analysis. Of 163 stimulations intra-operatively assessed by the surgeon as positive responses, 135 (83%) were confirmed after signal processing. In the following five consecutive experiments intra-operative online signal processing was realized and demonstrated reliable intra-operative Neuromonitoring signals of internal anal sphincter activity with significant increase during pelvic autonomic nerve stimulation [0.5 μV (interquartile range = 0.3–0.7) vs 4.8 μV (interquartile range = 2.5–7.5) ;P < 0.001]. Conclusion  Online signal processing of internal anal sphincter activity aids reliable identification of pelvic autonomic nerves with potential for improvement of intra-operative Neuromonitoring in pelvic surgery.

  • Selective Pelvic Autonomic Nerve Stimulation with Simultaneous Intraoperative Monitoring of Internal Anal Sphincter and Bladder Innervation
    European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes, 2011
    Co-Authors: W Kneist, D W Kauff, K P Koch, Irene Schmidtmann, Axel Heimann, Klauspeter Hoffmann, H Lang
    Abstract:

    Pelvic autonomic nerve preservation avoids postoperative functional disturbances. The aim of this feasibility study was to develop a Neuromonitoring system with simultaneous intraoperative verification of internal anal sphincter (IAS) activity and intravesical pressure. 14 pigs underwent low anterior rectal resection. During intermittent bipolar electric stimulation of the inferior hypogastric plexus (IHP) and the pelvic splanchnic nerves (PSN), electromyographic signals of the IAS and manometry of the urinary bladder were observed simultaneously. Stimulation of IHP and PSN as well as simultaneous intraoperative monitoring could be realized with an adapted Neuromonitoring device. Neurostimulation resulted in either bladder or IAS activation or concerted activation of both. Intravesical pressure increase as well as amplitude increase of the IAS Neuromonitoring signal did not differ significantly between stimulation of IHP and PSN [6.0 cm H(2)O (interquartile range [IQR] 3.5-9.0) vs. 6.0 cm H(2)O (IQR 3.0-10.0) and 12.1 μV (IQR 3.0-36.7) vs. 40.1 μV (IQR 9.0-64.3)] (p > 0.05). Pelvic autonomic nerve stimulation with simultaneous intraoperative monitoring of IAS and bladder innervation is feasible. The method may enable Neuromonitoring with increasing selectivity for pelvic autonomic nerve preservation. Copyright © 2011 S. Karger AG, Basel.

  • selective pelvic autonomic nerve stimulation with simultaneous intraoperative monitoring of internal anal sphincter and bladder innervation
    European Surgical Research, 2011
    Co-Authors: W Kneist, D W Kauff, K P Koch, Irene Schmidtmann, Axel Heimann, Klauspeter Hoffmann, H Lang
    Abstract:

    Background: Pelvic autonomic nerve preservation avoids postoperative functional disturbances. The aim of this feasibility study was to develop a Neuromonitoring system with simultan

John B Emans - One of the best experts on this subject based on the ideXlab platform.

  • intraoperative Neuromonitoring applications and issues in pediatric spinal deformity surgery
    Spine deformity, 2012
    Co-Authors: John B Emans
    Abstract:

    Intraoperative Neuromonitoring for deformity surgery in the very young or in neurologically abnormal patients may present special challenges for the surgeon and intraoperative monitoring team. Circumstances where monitoring may not be achievable, indications for monitoring in exceptional procedures, and safety considerations with monitoring itself are described for some less common pediatric spinal deformities. Strategies for responding to adverse intraoperative Neuromonitoring changes are reviewed. Awareness of these issues is useful for planning spinal deformity surgery in the young.

  • neurologic risk in growing rod spine surgery in early onset scoliosis is Neuromonitoring necessary for all cases
    Spine, 2009
    Co-Authors: Wudbhav N Sankar, David L Skaggs, John B Emans, David S Marks, John P Dormans, George H Thompson, Suken A Shah, Paul D Sponseller, Behrooz A Akbarnia
    Abstract:

    Study design Retrospective case series from a multicenter database. Objective To evaluate the risk of neurologic injury during growing rod surgeries and to determine whether intraoperative Neuromonitoring is necessary for all growing rod procedures. Summary of background data Although the use of growing rod constructs for early-onset spinal deformity has become a commonly accepted treatment, the incidence of neurologic events during growing rod surgeries remains unknown. Methods We reviewed data from a multicenter database on 782 growing rod surgeries performed in 252 patients. VEPTR devices and any constructs with rib attachments were excluded. A questionnaire was sent to all surgeons contributing cases requesting detailed information about all neurologic events associated with any growing rod surgery. Results There were 782 growing rod surgeries performed on 252 patients including 252 primary growing rod implantations, 168 implant exchanges, and 362 lengthenings. Five hundred sixty-nine of 782 (73%) cases were performed with Neuromonitoring. Only one clinical injury occurred in the series, resulting in an injury rate of 0.1% (1/782). This deficit occurred during an implant exchange while attempting pedicle screw placement, and resolved within 3 months. There were 2 cases with Neuromonitoring changes during primary implant surgeries (0.9%, 2/231), 1 change during implant exchanges (0.9%, 1/116), and 1 Neuromonitoring change during lengthenings (0.5%, 1/222). The single monitoring change that occurred during a lengthening was in a child with an intracanal tumor who also had a monitoring change during the primary surgery. There are anecdotal cases (outside this study group series) of Neuromonitoring changes during simple lengthenings in children with uneventful primary implantations. Conclusion Based on our study, the largest reported series of growing rod surgeries, the rate of Neuromonitoring changes during primary growing rod implantation (0.9%) and exchange (0.9%) justifies the use of intraoperative Neuromonitoring during these surgeries. As there were no neurologic events in 361 lengthenings in patients with no previous neurologic events, the question may be raised as to whether intraoperative Neuromonitoring is necessary for simple lengthenings in these patients. However, caution should be maintained when interpreting our results as anecdotal cases of neurologic changes from simple lengthenings do exist outside of this series.

  • efficacy of intraoperative neurologic monitoring in surgery involving a vertical expandable prosthetic titanium rib for early onset spinal deformity
    Journal of Bone and Joint Surgery American Volume, 2009
    Co-Authors: David L Skaggs, John B Emans, Paul D Choi, Christie Rice, Kit M Song, John T Smith, Robert M Campbell
    Abstract:

    Background: The vertical expandable prosthetic titanium rib (VEPTR) device is used in the treatment of thoracic insufficiency syndrome and certain types of early-onset spinal deformity. The purpose of this study was to evaluate the risk of neurologic injury during surgical procedures involving use of the VEPTR and to determine the efficacy of intraoperative spinal cord Neuromonitoring. Methods: Data were collected prospectively during a multicenter study. Surgical procedures were divided into three categories: primary device implantation, device exchange, and device lengthening. Further retrospective evaluation was undertaken in cases of neurologic injury or changes detected with Neuromonitoring. Results: There were 1736 consecutive VEPTR procedures at six centers: 327 (in 299 patients) consisted of a primary device implantation, 224 were a device exchange, and 1185 were a device lengthening. Perioperative clinical neurologic injury was noted in eight (0.5%) of the 1736 cases: these injuries were identified after five (1.5%) of the 327 procedures for primary device implantation, three (1.3%) of the 224 device exchanges, and none of the 1185 device-lengthening procedures. Of the eight cases of neurologic injury, six involved the upper extremity and two involved the lower extremity. The neurologic deficit was temporary in seven patients and permanent in one patient, who had persistent neurogenic arm and hand pain. Intraoperative Neuromonitoring demonstrated changes during six (0.3%) of the 1736 procedures: five (1.5%) of the 327 procedures for primary device implantation and one (0.08%) of the 1185 device-lengthening procedures. The surgery was altered in all six cases, with resolution of the monitoring changes in five cases and persistent signal changes and a neurologic deficit (upper-extremity brachial plexopathy) in one. Two patients had false-negative results of monitoring of somatosensory evoked potentials, and one had false-negative results of monitoring of somatosensory evoked potentials and motor evoked potentials during implant surgery; two had a brachial plexopathy and one had monoplegia postoperatively, with all three recovering. Conclusions: Neurologic injury during VEPTR surgery occurs much more frequently in the upper extremities than in the lower extremities. The rates of potential neurologic injuries (neurologic injuries plus instances of changes detected by monitoring) during primary implantation of the VEPTR (2.8%) and during exchange of the VEPTR (1.3%) justify the use of intraoperative Neuromonitoring of the upper and lower extremities during those procedures. As Neuromonitoring did not demonstrate any changes in children without a previous VEPTR-related monitoring change and there were no neurologic injuries during more than 1000 VEPTR-lengthening procedures, intraoperative Neuromonitoring may not be necessary during those procedures in children without a history of a neurologic deficit during VEPTR surgery. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

Rick Schneider - One of the best experts on this subject based on the ideXlab platform.

Related terms

Neuromonitoring - 15 days free trial to Access Experts & Abstracts