Which surgical interventions are suited for nerve monitoring (intraoperative neuromonitoring) and what are its advantages?

Intraoperative neuromonitoring (IONM) can be especially useful for surgical procedures where nerves are located in or near the surgical field. Pressure or traction on the nerve is often enough to result in damage.

Common and established application fields include:

>> Surgery for thyroid diseases

>> Surgery in the small pelvis, e.g. on the bowel (removal of colorectal cancer)

>> Surgery on the brain and central nervous system (removal of tumours, etc.)

>> Surgery on the spine (removal of tumours/scoliosis correction/vertebral fractures/herniated discs, etc.)

>> Surgery on the parotid gland

>> Surgery on the carotid artery

>> Targeted nerve monitoring during surgery can better prevent nerve damage and thus greatly reduce the risk of secondary issues.

>> Increased safety during surgery for you as a patient.

>> Less resulting damage, such as paralysis, neurological deficits or muscle weaknesses. The quality of life is maintained after the surgical interventions.

>> Reliable record of the functionality of the nerve after the surgery and the related bodily functions.

>> In this way, any necessary therapies can be initiated at an early stage in order to enable the fullest possible rehabilitation.

>> Nerves are monitored and this process is recorded for better documentation.^[1]

What consequential damage can be prevented by using IONM?

Depending on the disease and the surgical method, neuromonitoring can help to avoid certain unwanted side effects. Here is a list of the most common consequences of nerve damage.

>> Thyroid: hoarseness, loss of voice and difficulty breathing, sometimes even tracheotomy

>> Small pelvis/bowel: incontinence, bladder dysfunction and sexual dysfunction

>> Brain and nervous system: neurological deficits, paralysis, visual impairment or speech disorders

>> Spine: paralysis of the affected parts of the body

>> ENT and otology: signs of paralysis in and around the surgical field, e.g. paralysis of the facial muscles or hearing loss

It is important to note that the prevention of surgical nerve damage through the use of IONM depends largely on the application field, the type of anaesthesia and the surgical method. Even the use of IONM does not offer 100 per cent safety. However, when used correctly, IONM minimises the risk of nerve damage during surgery and can help prevent consequential damage.^[2]

2. Ibid.