recurrent laryngeal nerve function

(Sep-2003 Q13) How can recurrent laryngeal nerve function be assessed in the postoperative period?

RLN function can be assessed via invasive and non-invasive means

invasive test: nasoendoscopy to see weakness of unilateral glottis- inability to abduct? (remains adducted)

EMG?

non invasive: -clinical tests: presence of a leak if the patient is intubated and if the cuff is allowed to deflate, presence of stridor

RLN function can be monitored intra-op : conventional: needle electrode into cricoarytenoid. New: endoscopic visualisation (eg LMA)



The RLN (branch of the Vagus) is a mixed motor, sensory and autonomous nerve thatinnervates all intrinsic muscles of the larynx with the exceptionof the cricothyroid muscle, which is innervated by the superiorlaryngeal nerve.
ops at risk: thyroidectomy (<5%)/ACDF, carotid endarterectomy

http://www.omjournal.org/images/59_M_Deatials_Pdf_.pdf retrospective review

good review article