Avoidance of nerve damage and secondary issues during surgery

Access for patients

Ask your treatment team about intraoperative neuromonitoring (nerve monitoring).

For many diseases, surgical interventions are the only or last option for healing or preserving functionality. Very often they are necessary, even though in many cases they involve the risk of nerve damage and thus consequential damage.

Due to the high stress on the body and the risk of nerve damage, it is especially important for patients to have confidence in the treatment and the surgeons. Therefore, if possible, you should inform yourself about the most conservative surgical method prior to a surgical procedure in order to better assess nerve damage and keep the risk of secondary issues as low as possible.

What does this website offer?

This website is designed to help you as a patient in your decision-making process. If you are having surgery on a part of the body which is close to important nerve pathways, it may be beneficial that the surgical treatment is accompanied by intraoperative neuromonitoring. This way, it is possible to monitor and protect nerves during surgery and thus better prevent consequences such as paralysis or loss of sensation.^{[1] [2] [3]}

In many areas, such as thyroid surgery (e.g. removal of thyroid cancer), neuromonitoring is a standard technique and helps to prevent nerve damage that can lead to hoarseness, vocal changes and respiratory failure.^[3] In some other areas, intraoperative nerve monitoring has just been introduced, but is already showing promising results in preventing nerve damage.^[1] Therefore, it is important that you ask your surgeons about the use of neuromonitoring.

What exactly is intraoperative neuromonitoring?

The term intraoperative neuromonitoring refers to the monitoring of the nervous system and individual nerves during surgical procedures. In many surgical interventions, nerves are located in or near the surgical field and are therefore in direct danger of being injured or impaired, resulting in nerve damage and deficits in the patients.

Special devices and electrodes can be used to deliver targeted electrical stimulation with a small impulse to the nerve tissue. This allows the surgeons to identify the nerves and monitor their function. Depending on the surgical field or case, this can be done several times or even continuously for the entire duration of the surgery.^[3] The surgeons are thus in a better position to prevent potential nerve damage. The functionality of the nerves and the related bodily functions are preserved, which helps to maintain patients’ quality of life.

Intraoperative neuromonitoring is becoming increasingly common in many surgical fields due to its benefits for patient safety and reduction of nerve damage.

References

1. Sala, F. et al. Motor Evoked Potential Monitoring Improves Outcome after Surgery for Intramedullary Spinal Cord Tumors: A Historical Control Study: Neurosurgery 58, 1129–1143 (2006).

2. Martin, W. H. & Stecker, M. M. ASNM Position Statement: Intraoperative Monitoring of Auditory Evoked Potentials. J. Clin. Monit. Comput. 22, 75–85 (2008).

3. Mangano, A. et al. Evidence-based analysis on the clinical impact of intraoperative neuromonitoring in throid surgery: State of the art and future perspectives. Surg Technol Int 25, 91–6 (2014).