Nerve Monitoring for Vocal Cord Protection in Surgery

This trial tests whether an intraoperative laryngeal nerve monitor, a special device used during surgery, can protect the nerve controlling a child's vocal cords. Damage to this nerve can impair speaking, swallowing, and breathing. Some children will undergo surgery with this device, while others will have surgery without it. The trial aims to determine if the device reduces the risk of nerve injury. It is suitable for children undergoing certain throat, chest, or heart surgeries at Stollery Children's Hospital. As an unphased trial, it provides a unique opportunity for patients to contribute to innovative research that could enhance surgical outcomes for children.

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial team or your doctor.

Research has shown that using monitors to check the laryngeal nerve during surgery is generally safe. These monitors help locate and protect the nerve that controls vocal cords, which is crucial during major changes in the throat area.

For example, one study with over 2,500 patients found that this monitor significantly reduced the risk of nerve damage. Another study demonstrated that it greatly lowers the chance of temporary nerve injuries, aiding faster voice recovery after surgery.

Unlike the standard surgical care that doesn't use nerve monitoring, the intraoperative laryngeal nerve monitor aims to protect vocal cords during surgery by actively tracking the recurrent laryngeal nerve. Researchers are excited about this technique because it offers real-time feedback during surgery, potentially reducing the risk of nerve injury and preserving vocal function. This approach could lead to safer outcomes for patients undergoing procedures near the vocal cords, offering a significant improvement over traditional methods that do not provide this level of nerve protection.

This trial will compare standard care during surgery with the use of intraoperative nerve monitoring (IONM) to protect the vocal cords. Research has shown that IONM can reduce the risk of vocal cord nerve injury during surgery. One study found that the risk of injury to the recurrent laryngeal nerve dropped from 3.2% to 2.3% with IONM. Another study demonstrated that temporary vocal cord paralysis occurred less often with IONM—2.0% compared to 10.0% without it. In children, IONM effectively prevents nerve injuries that can affect vocal cord movement. Overall, IONM offers better protection for the vocal cords during surgeries.²³⁴⁵⁶