Table 3.

Common RLN injuries models used for IONM training courses in animal laboratories.

Traction and compression injury Traction stress can be experimentally induced in RLNs to observe accompanying electrophysiological EMG changes (degradation and recovery). A vascular loop (1.3-mm in width) can be wrapped around the nerve and retracted with a force gauge under varying tension force to simulate an RLN trapped against a dense, fibrous band or an RLN trapped against a crossing artery at the region of Berry’s ligament caused by medial traction of the thyroid lobe.

Thermal injury During use of different energy-based devices, including activation study (activation at varying distances from the RLN) and cooling study (cooling for varying time intervals or by muscle touch maneuver before contact with the RLN), C-IONM can be used to obtain dynamic EMG data that can be used to detect thermal injury and to define the safety parameters of the tested devices.

RLN, recurrent laryngeal nerve; IONM, Intraoperative neural monitoring; C-IONM, Continuous Intraoperative neural monitoring; EMG, Electromyography.