Neuromonitoring

Paralysis of the vocal cord nerves (recurrent paresis) is one of the dreaded complications in thyroid and parathyroid surgery. A unilateral recurrent paresis leads to a standstill of one vocal cord. In most cases, the voice is then hoarse. The frequencies given in the literature vary from less than one percent to more than 20 percent in second and multiple operations (recurrent surgery). Paralysis of both vocal cord nerves often results in respiratory distress, which may require a tracheotomy.

However, the majority of vocal cord paralyses that occur during surgery on the thyroid or parathyroid gland regress. To keep the risk of recurrent paresis as low as possible, we monitor the vocal cord nerve by means of neuromonitoring. For this purpose, the vocal cord nerve (nervus recurrens) is electrically stimulated by a probe during the operation. The stimulation causes the muscle supplied by the nerve - here the vocalis muscle - to contract. This muscle is located in the larynx and moves the vocal cord. An electrode placed in this muscle derives corresponding signals and displays them acoustically. In this way it is possible to localize the vocal cord nerve and to check its integrity during the operation.

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