Abstract
Objective: Left Recurrent Laryngeal Nerve (RLN) palsy is a well known complication of cervical mediastinoscopy and is not infrequent if specifically looked for. Electro-physiological monitoring of the RLN is common practice in thyroid surgery and has greatly improved outcomes. We applied the same technique during cervical video-mediastinoscopy.
Highlights
Since the advent of EBUS and EUS the frequency of cervical mediastinoscopy has greatly diminished
Indication for mediastinoscopy was staging for lung cancer in 6 patients and biopsy of undiagnosed mediastinal lesions in the remaining 6 patients
Intraoperative electrophysiological monitoring to identify the left Recurrent Laryngeal Nerve (RLN) was feasible and safe in the 12 patients analysed in this study
Summary
Since the advent of EBUS and EUS the frequency of cervical mediastinoscopy has greatly diminished. It is, still an important tool in the staging for non small cell lung cancer (NSCLC) and in the diagnosis of mediastinal lymphadenopathies and other mediastinal lesions. The same technology can be used during cervical mediastinoscopy to help identifying with certainty the left RLN and, hopefully, to help preserving it. The aim of this preliminary study was to evaluate the feasibility and safety of using intra-operative neuromonitoring during mediastinoscopy to identify the left RLN and to report pitfalls and difficulties in using this technique
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