OP81 – Development of a novel detachable magnetic nerve stimulator for intraoperative neuromonitoring

     

    Lee, Byung-Joo1, Shin, Sung-Chan1, Wang, Soo-Geun1; Lee, Jin-Choon2; Ro, Jung-Hoon3; Sung, Eui-Suk2
    1 Department of Otolaryngology – Head and Neck Surgery, College of Medicine, Pusan National University, Pusan, South Korea
    2 Department of Otolaryngology – Head and Neck Surgery, College of Medicine, Pusan National University, Yangsan, South Korea
    3 Department of Biomedical Engineering, Pusan National University Hospital, Pusan, South Korea

     

    Background:  Recurrent laryngeal nerve palsy is a serious complication of thyroid and parathyroid surgery. During intraoperative neuromonitoring of the recurrent laryngeal nerve in thyroid surgery, repeated shifting between surgical instrument and nerve stimulator is troublesome and time consuming. Therefore, we developed a simple detachable magnetic nerve stimulator that can be connected to all metallic surgical instruments. This study aimed to investigate the feasibility and efficacy of a detachable magnetic nerve stimulator for intraoperative neuromonitoring in animal and human.

    Methods: 
    Eight recurrent laryngeal nerves in four pigs and thirteen recurrent laryngeal nerves in nine patients that underwent thyroidectomy were tested. We developed a detachable nerve stimulator that combined the surgical instrument and nerve-stimulating probe. We evaluated the electromyography amplitudes of the eight recurrent laryngeal nerves at pig and thirteen recurrent laryngeal nerves at patients using conventional nerve probes and surgical instruments with novel detachable magnetic nerve stimulator.

    Results: The amplitudes of the electromyographic recordings of the eight recurrent laryngeal nerves at pigs and thirteen recurrent laryngeal nerves at patients were analyzed. The detachable magnetic nerve stimulator was feasible and safe in all cases. There was no significant difference in the amplitude of electromyography of the recurrent laryngeal nerve between instruments

    Discussion & Conclusion: The application of stimulating dissection using a detachable magnetic nerve stimulator during thyroidectomy with intraoperative neuromonitoring is simple, convenient, and effective. It provides surgeons with real-time feedback of the electromyographic response during intermittent intraoperative neuromonitoring. We believe that this novel device could be an essential guide for most surgeons, especially for less experienced head and neck surgeons.

     

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