Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 2 de 2
Filter
Add more filters










Database
Language
Publication year range
1.
J Nucl Med Technol ; 42(1): 75-6, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24480917

ABSTRACT

This case study illustrates the pattern and significance of the pinwheel sign, a SPECT artifact from rotational head motion that can complicate the diagnosis of Parkinson disease. Monitoring the patient during image acquisition is crucial since rotational motion artifacts are difficult to identify on raw or processed images and may lead to incorrect interpretation of findings.


Subject(s)
Artifacts , Dopamine Plasma Membrane Transport Proteins/metabolism , Image Processing, Computer-Assisted , Tomography, Emission-Computed, Single-Photon , Aged , Head/physiology , Humans , Male , Movement , Parkinson Disease/diagnostic imaging , Parkinson Disease/metabolism
2.
Surgery ; 154(4): 704-11; discussion 711-3, 2013 Oct.
Article in English | MEDLINE | ID: mdl-24008089

ABSTRACT

BACKGROUND: Despite widespread use of intraoperative nerve monitoring (IONM) as an adjunct to visual identification of the recurrent laryngeal nerve (RLN), published studies have shown little or no benefit. No long-term studies exist detailing the effect of experience gained from IONM on the rate of RLN injury. The aim of this study was to evaluate the impact of IONM feedback on surgical outcomes over time at a single institution. METHODS: We conducted retrospective analysis of prospectively gathered data for 1,936 patients including 3,435 nerves at risk between March 2004 and September 2011. Each RLN was analyzed for the specific, unilateral operative procedure that placed the nerve at risk of injury. The primary outcome measures included temporary vocal cord palsy and permanent vocal cord paralysis or paresis as determined by intraoperative loss of RLN function and postoperative laryngoscopy. Additional measures included instances where IONM assisted the surgeon's localization of the RLN. RESULTS: Of the 3,435 nerves at risk, 105 (3.06%) were injured, 4 had permanent paralysis (0.12%), and 7 had paresis (0.20%). Over time, a decrease in RLN injury was seen per successive operative year for thyroid lobectomy with paratracheal lymph node dissection with or without parathyroidectomy (odds ratio, 0.98; 95% confidence interval, 0.97-1.00; P = .04); the rate of nerve injury stabilized after 20 months of continued use of nerve monitoring. IONM particularly assisted the surgeon with identification of 108 nerves at risk (3.14%) with aberrant anatomy, and with identification of 236 nerves at risk (6.87%) during difficult dissections. CONCLUSION: With experience, routine use of IONM during thyroid and parathyroid operations significantly decreased the incidence of injury to the RLN for thyroid lobectomy with paratracheal lymph node dissection and provided useful assistance with RLN identification for 10% of nerves at risk.


Subject(s)
Monitoring, Intraoperative , Parathyroid Glands/surgery , Recurrent Laryngeal Nerve/physiopathology , Thyroid Gland/surgery , Electromyography , Female , Humans , Male , Middle Aged , Recurrent Laryngeal Nerve Injuries/prevention & control , Retrospective Studies
SELECTION OF CITATIONS
SEARCH DETAIL
...