ABSTRACT
Background and Objectives@#Variable types of electrodes for intraoperative neuromonitoring (IONM) during thyroid surgery have been introduced to make up for the shortcomings of conventional endotracheal electromyogram tube. In this study, we sought to evaluate the efficacy of transcutaneous adhesive skin electrodes for IONM of recurrent laryngeal nerve (RLN) during thyroidectomy.Subjects and Method A total 97 nerves at risk of 80 patients were enrolled in this study. Two disposable adhesive skin electrodes were attached at both upper margins of thyroid cartilage. Using NIM 3.0 system (Medtronic), we recorded the amplitude and latency of signals of vagus nerve and RLN following the standard procedure of IONM. Clinicopathologic factors as well as the preoperative and postoperative vocal cord functions of the patients were analyzed. @*Results@#IONM was successful in all nerves at risk without any false loss of signals. There were no complications nor any significant time delay due to adhesive skin electrodes. The mean amplitudes from the vagus nerve (V1) and RLN (R1) were 230.64 µV and 293.48 µV, respectively. Two nerves at risk showed loss of signal and the two patients showed postoperative temporary vocal cord paralysis. The amplitude of signals from the vagus nerve (V1, V2) was significantly higher in the lower body mass index (BMI) group compared to that of the higher BMI group. @*Conclusion@#IONM using transcutaneous skin electrodes may be considered as an alternative technique for IONM during thyroid surgery.
ABSTRACT
Perioperative stroke is one of the most fatal complications for patients as well as for doctors. It is defined as a brain infarction or hemorrhage, occurring during or within 30 days after a surgical procedure. Most of the perioperative strokes have ischemic etiology while only 1% has hemorrhagic etiology, according to one study. The incidence of perioperative stroke is influenced by the complexity and type of the surgery. Generally, its incidence is very low, being about to 0.1-1.9%, with majority of the cases pertaining to cardiac, vascular, neurological surgeries. Based on our research, most cases are perioperative strokes that occur after cardiac and vascular surgeries. Here we report two cases of cerebral infarction after endoscopic sinus surgery, which are very rare.
ABSTRACT
BACKGROUND AND OBJECTIVES@#Sudden sensoryneural hearing loss (SSNHL) is an otological emergency disease of a non-specific cause. If there is no improvement or if the degree of hearing loss is severe, patients are often referred to other medical institution. Many papers have reported regarding the treatment results of SSNHL, however, most of them failed to mention the fact that patients were referred from other clinics after steroid treatment. This paper would like to compare the treatment results between patient groups who had been referred following steroid treatment and those who received steroid treatment for the first time.SUBJECTS AND METHOD: We retrospectively analyzed 127 patients from January 2015 to August 2017. Patients who received steroid treatment for the first time were classified as group 1; those who had received steroid treatment at another hospital and those who were re-treated were classified as group 2. The treatment results of each group were evaluated.@*RESULTS@#According to the results of this study, the recovery rates for group 1 and 2 were 66.7% and 31.4%, respectively.@*CONCLUSION@#Most of the previous studies on the treatment results of sudden hearing loss were performed in tertiary medical institutions. It is likely that the treatment results of patients who recovered after treatment in the primary and secondary medical institutions were missed, which means that the results of steroid therapy may be better than those reported previously.