ApplicationsPatients

Patient safety through nerve monitoring

Intraoperative neuromonitoring (IONM) involves monitoring the nervous system and individual nerves during surgery. The aim is to avoid nerve damage and secondary diseases during surgery. Ask your treatment team about intraoperative neuromonitoring (nerve monitoring).

Why is intraoperative neuromonitoring important?

Information and support

Use of the surgical technique

What exactly is intraoperative neuromonitoring?

Intraoperative neuromonitoring

DEFINITION

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 at risk of being injured or impaired. This can result in nerve damage and loss of function in patients.

Nerve monitoring during surgical interventions

PROCEDURE

Nerve monitoring during surgical interventions

Special devices and electrodes can be used to deliver targeted electrical stimulation with a small “impulse” to the nerve tissue. This enables surgeons to identify the nerves and also 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]

Numerous advantages for patients

ADVANTAGES

Numerous advantages for patients

Intraoperative neuromonitoring helps surgeons to better prevent potential nerve damage. The functionality of the nerves and the related bodily functions are preserved, which can be decisive for the quality of life. Monitoring is being used more and more frequently due to its advantages in terms of patient safety and the reduction of nerve damage.

Overview of intraoperative neuromonitoring (IONM)

Application fields

OVERVIEW

Application fields

Intraoperative neuromonitoring (IONM) can be especially useful for surgical procedures where nerves are located in or near the surgical field. A bruise or a tension on the nerve is often enough to cause unwanted consequential damage.

Common and established application fields are, for example:

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 corrections, vertebral fractures, herniated discs, etc.)
Surgery on the parotid gland
Surgery on the carotid artery

For which surgical procedures is IONM helpful?

Minimisation of consequential damage

OVERVIEW

Minimisation of consequential damage

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

Thyroid: hoarseness, loss of voice and difficult breathing up to tracheotomy
Small pelvis/bowel: incontinence, bladder dysfunction and sexual dysfunction
Brain and nervous system: neurological deficits, paralysis, visual disturbances or speech disorders
Spine: paralysis of the affected parts of the body
Vessels and glands: signs of paralysis in and around the surgical field, e.g. paralysis of the face 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 security. However, when used correctly, IONM minimises the risk of nerve damage during surgery and can help prevent consequential damage.^[5]

What consequential damage can be prevented by using IONM?

Advantages of IONM

OVERVIEW

Advantages of IONM

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

For you as a patient, this means:

Increased safety during surgery
Less consequential damage, such as paralysis, neurological deficits or muscle weakness and quality of life is maintained after surgery
Nerve monitoring for better logging and documentation^[4]
A reliable statement about the functionality of the nerve after 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.

What advantages does IONM offer me as a patient?

All diseases at a glance

In this overview you will find in particular diseases for which the use of intraoperative neuromonitoring is recommended in surgical treatment and which are most frequently accompanied by neuromonitoring.