喉返神经的冷暴露：一项猪连续术中神经监测模型研究。

文献信息

中文摘要

背景： 组织暴露于低温在临床实践中很常见，但喉返神经（RLN）暴露于冷环境的安全性仍不明确。本研究评估了冷暴露对RLN功能的温度依赖性影响。
方法： 采用猪连续术中神经监测（C-IONM）模型，评估16条RLN在四种温度条件下暴露后的肌电图（EMG）变化：室温水、冷水、冰水和冰块。每次暴露持续1分钟，随后进行20分钟的EMG监测。
结果： 室温水和冷水引起无或仅轻度EMG变化，并可完全恢复。冰水引起中度至重度紊乱，部分可逆。冰块暴露产生最严重的影响，包括部分神经出现短暂信号丢失和恢复不完全。
结论： 低于3°C的冷暴露可导致显著的RLN功能障碍。这些发现提供证据表明，被认为具有神经保护作用的接近冰点的温度反而带来独特的医源性神经损伤风险，强调临床应用中需谨慎。

英文摘要

BACKGROUND: Tissue exposure to cold temperatures is common in clinical practice, yet the safety of exposing the recurrent laryngeal nerve (RLN) to cold remains unclear. This study evaluated temperature-dependent effects of cold exposure on RLN function.
METHODS: A porcine continuous intraoperative neuromonitoring (C-IONM) model was used to assess electromyographic (EMG) changes in 16 RLNs exposed to four temperature conditions: room temperature water, cold water, ice water, and ice block. Each exposure lasted 1 min, followed by 20 min of EMG monitoring.
RESULTS: Room temperature and cold water caused no or only mild EMG changes with complete recovery. Ice water induced moderate to severe disturbances with partial reversibility. Ice block exposure produced the most severe effects, including transient loss of signal and incomplete recovery in some nerves.
CONCLUSIONS: Cold exposure below 3°C can induce significant RLN dysfunction. These findings provide evidence that near-freezing temperatures, presumed to be neuroprotective, instead carry a distinct risk of iatrogenic neural injury, underscoring the need for caution in clinical applications.