Intraoperative Neurophysiological Monitoring for the Phrenic Nerve: Case Illustrations

TY - CHAP

T1 - Intraoperative Neurophysiological Monitoring for the Phrenic Nerve

T2 - Case Illustrations

AU - DiAngelo, Joseph

AU - Garcia, Pedro

AU - Lopazanski, Thomas

AU - Deutsch, Alan D.

AU - Shifrin, Alexander L.

N1 - Publisher Copyright: © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.

PY - 2023/1/1

Y1 - 2023/1/1

N2 - The phrenic nerves originate from the anterior rami of the third through fifth cervical nerve roots bilaterally and supply motor innervation to the diaphragms. Injury to the phrenic nerve can result in paralysis of the ipsilateral diaphragm, leading to symptoms of dyspnea. As a portion of the phrenic nerve travels through the neck, there is a potential for injury to the nerve during the radical neck dissection. The phrenic nerve is monitored by using a single long 19 mm subdermal needle electrode placed at the level of the diaphragm. A second reference needle electrode is placed at the xiphoid area of the sternum. A Prass monopolar cathode stimulator probe is used by the surgeon to directly stimulate and identify the phrenic nerve. A reference stimulator anode electrode is placed in the ipsilateral trapezius muscle. Stimulus intensities of 3.0-8.0 milliamps (mA) are used. All waveforms and data were obtained utilizing Cadwell Cascade® intraoperative monitoring recording equipment.

AB - The phrenic nerves originate from the anterior rami of the third through fifth cervical nerve roots bilaterally and supply motor innervation to the diaphragms. Injury to the phrenic nerve can result in paralysis of the ipsilateral diaphragm, leading to symptoms of dyspnea. As a portion of the phrenic nerve travels through the neck, there is a potential for injury to the nerve during the radical neck dissection. The phrenic nerve is monitored by using a single long 19 mm subdermal needle electrode placed at the level of the diaphragm. A second reference needle electrode is placed at the xiphoid area of the sternum. A Prass monopolar cathode stimulator probe is used by the surgeon to directly stimulate and identify the phrenic nerve. A reference stimulator anode electrode is placed in the ipsilateral trapezius muscle. Stimulus intensities of 3.0-8.0 milliamps (mA) are used. All waveforms and data were obtained utilizing Cadwell Cascade® intraoperative monitoring recording equipment.

KW - Intraoperative neurophysiological monitoring

KW - Neurological deficit prevention

KW - Phrenic nerve

UR - https://www.scopus.com/pages/publications/85206041630

U2 - 10.1007/978-3-031-24613-5_13

DO - 10.1007/978-3-031-24613-5_13

M3 - Chapter

SN - 9783031246128

SP - 65

EP - 67

BT - Atlas of Intraoperative Cranial Nerve Monitoring in Thyroid and Head and Neck Surgery

PB - Springer International Publishing

ER -