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Head Neck. 2018 Dec;40(12):2657-2663. doi: 10.1002/hed.25391. Epub 2018 Nov 22.

Diagnosis, anatomy, and electromyography profiles of 73 nonrecurrent laryngeal nerves.

Author information

1
Jilin Provincial Key Laboratory of Surgical Translational Medicine, China Japan Union Hospital of Jilin University, Division of Thyroid Surgery, Changchun City, Jilin Province, China.
2
Division for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood "G Barresi," University Hospital G Martino, University of Messina, Messina, Italy.

Abstract

BACKGROUND:

The purpose of this work was to compare methods of detecting nonrecurrent laryngeal nerves (NRLNs).

METHODS:

Specificity and sensitivity were compared in three NRLN detection methods: CT, electromyography (EMG), and A-B point comparison.

RESULTS:

A total of 73 intraoperative pictures and 36 CT details of NRLNs are presented. Incidence of NRLN was 0.39%. Type I NRLN accounted for 50.7%, type IIA 45.2%, type IIB 4.1%. The NRLN median latency was 2.13 ms vs 3.00 ms median in an RLN control group (P < .001). When the threshold was set to 2.5 ms, EMG latency detection had 96.7% sensitivity and 91.6% specificity for detecting NRLN, and the A-B point comparison algrithm had 97.3% sensitivity and 92.5% specificity. Combining EMG latency detection with A-B point comparison achieved 100% sensitivity and specificity for detecting NRLN.

CONCLUSION:

This is the largest series of NRLN presented in the literature. Latency shorter than 2.50 ms combined with the A-B point comparison method is the ideal algorithm procedure for early NRLN identification.

KEYWORDS:

amplitude; anatomy; embryology; identification; latency; neuromonitoring; nonrecurrent laryngeal nerve

PMID:
30466175
DOI:
10.1002/hed.25391

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