Traction injury of the recurrent laryngeal nerve: Results of continuous intraoperative neuromonitoring in a swine model

Background Recurrent laryngeal nerve (RLN) palsy is the most serious complication after thyroidectomy. However, little is known about the degree of traction injury that causes loss of signal. The purpose of this study was to evaluate traction injuries in the swine RLN using continuous intraoperative...

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Bibliographic Details
Published in:	Head & neck Vol. 38; no. 4; pp. 582 - 588
Main Authors:	Lee, Hye Yoon, Cho, Young Geon, You, Ji Young, Choi, Byoung Ho, Kim, Joon Yub, Wu, Che-Wei, Chiang, Feng-Yu, Kim, Hoon Yub
Format:	Journal Article
Language:	English
Published:	United States Blackwell Publishing Ltd 01-04-2016 Wiley Subscription Services, Inc
Subjects:	Animals Disease Models, Animal Electromyography intraoperative neuromonitoring Monitoring, Intraoperative - methods recurrent laryngeal nerve Recurrent Laryngeal Nerve - physiopathology Recurrent Laryngeal Nerve Injuries - diagnosis Recurrent Laryngeal Nerve Injuries - etiology Recurrent Laryngeal Nerve Injuries - physiopathology Swine swine model thyroidectomy Thyroidectomy - adverse effects Traction traction injury intraoperative neuromonitoring traction injury swine model thyroidectomy recurrent laryngeal nerve
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Summary:	Background Recurrent laryngeal nerve (RLN) palsy is the most serious complication after thyroidectomy. However, little is known about the degree of traction injury that causes loss of signal. The purpose of this study was to evaluate traction injuries in the swine RLN using continuous intraoperative neuromonitoring (IONM) and determine the traction power that results in loss of signal. Methods Thirteen swine underwent traction injury to the RLNs with continuous IONM, and stress‐strain curves were determined for 8 nerves using the universal material testing machine in an ex vivo model. Results Traction injury at a mean power of 2.83 MPa caused loss of signal. The mean physiologic limit strain and tensile strength of the swine RLNs were found to be 15.0% and 4.9 MPa, respectively. Histological analysis showed no abnormal structural findings. Conclusion Traction injury of swine RLNs causes loss of signal at a power of 2.83 MPa. However, all injured nerves recovered within 7 days with no observed structural damage. © 2015 Wiley Periodicals, Inc. Head Neck 38: 582–588, 2016
Bibliography:	ark:/67375/WNG-WCLZ76DX-8 ArticleID:HED23934 istex:19C21DD5D420C2B0682BAED81B39F3A98A15CE42 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1043-3074 1097-0347
DOI:	10.1002/hed.23934