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GlideScope-assisted nerve integrity monitoring tube placement for intra-operative recurrent laryngeal nerve monitoring

Published online by Cambridge University Press:  26 October 2012

S P Kanotra ,
D B Kuriloff ,
J Lesser  and
F Rest-Flarer
S P Kanotra*
Affiliation:
Center for Thyroid and Parathyroid Surgery, Department of Otolaryngology/Head and Neck Surgery, St. Luke's-Roosevelt Hospital Center, New York, USA
D B Kuriloff
Affiliation:
Center for Thyroid and Parathyroid Surgery, Department of Otolaryngology/Head and Neck Surgery, St. Luke's-Roosevelt Hospital Center, New York, USA
J Lesser
Affiliation:
Department of Anesthesiology, St. Luke's-Roosevelt Hospital Center, New York, USA
F Rest-Flarer
Affiliation:
Department of Anesthesiology, St. Luke's-Roosevelt Hospital Center, New York, USA
*
Address for correspondence: Dr S P Kanotra, 425 West 59th St, 10th Floor, New York, 10019, USA Fax: +01 212 523 6364, E-mail: dr.sohitpaul@gmail.com
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Abstract

Objective:

The proper positioning of the Nerve Integrity Monitoring® endotracheal tube during recurrent laryngeal nerve monitoring is of paramount importance. This article describes our experience with the GlideScope® and explains how it can facilitate the accurate placement of the Nerve Integrity Monitoring endotracheal tube.

Methods:

Endotracheal intubation with the Nerve Integrity Monitoring endotracheal tube was performed in 250 patients undergoing thyroidectomies using the GlideScope video laryngoscope. The correct positioning of the tube was determined according to impedance values of less than 5 kohm and an impedance imbalance of less than 1 kohm.

Results:

Successful intubation was achieved in all cases. The GlideScope aided the correct placement of the Nerve Integrity Monitoring endotracheal tube in the majority of the cases.

Conclusion:

The GlideScope provides an excellent means to ensure the correct positioning of the Nerve Integrity Monitoring tube. It allows both the surgeon and the anaesthesiologist to participate in the intubation process and confirm correct placement of the tube, whilst also allowing gentle intubation with improved visibility.

Keywords

Monitoring, IntraoperativeIntubation, EndotrachealThyroidectomyRecurrent Laryngeal NerveLaryngoscopy
Type
Short Communication
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 12 , December 2012 , pp. 1271 - 1273
Copyright
Copyright © JLO (1984) Limited 2012

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Footnotes

Presented as a poster at the annual meeting of the American Academy of Otolaryngology – Head and Neck Surgery Foundation, 11–14 September 2011, San Francisco, California, USA.

References

1Lu, IC, Chu, KS, Tsai, CJ, Wu, CW, Kuo, WR, Chen, HY et al. Optimal depth of NIM EMG endotracheal tube for intraoperative neuromonitoring of the recurrent laryngeal nerve during thyroidectomy. World J Surg 2008;32:1935–9CrossRefGoogle ScholarPubMed
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3Xue, FS, Zhang, GH, Liu, J, Li, XY, Yang, QY, Xu, YC et al. The clinical assessment of Glidescope in orotracheal intubation under general anesthesia. Minerva Anestesiol 2007;73:451–7Google ScholarPubMed
4Randolph, GW, Dralle, H, Abdullah, H, Barczynski, M, Bellantone, R, Brauckhoff, M et al. Electrophysiologic recurrent laryngeal nerve monitoring during thyroid and parathyroid surgery: international standards guideline statement. Laryngoscope 2011; 121 (suppl 1): 1–16CrossRefGoogle ScholarPubMed