Background
Continuous intraoperative neuromonitoring (C‐IONM) is a new technology and it is appropriate to analyze its safety.
Methods
C‐IONM was performed according to a standardized technique to control any adverse events and electrode positioning issues.
Results
Four hundred vagal nerve dissections were analyzed considering vagal nerve diameter, mean time effort for C‐IONM probe positioning, and electrode dislocation rate. A significant superior dislocation rate in case of: (a) when a 3 mm automatic periodic stimulating (APS) electrode size was used in a vagal nerve diameter <2 mm; (b) anterior access; and (c) vagal nerve A subtype in relation (p < .05). No related additional local or systemic morbidity was registered in this series. There was a statistically significant positive relationship between increased diameter of vagal nerve and increased electromyography (EMG) amplitude (p = .03). There was also a significant increase of amplitude between initial and final vagal nerve stimulation in uneventful cases (p = .02).
Conclusion
We analyzed the technical issues to achieve improved vagal nerve critical view of safety dissection, stimulation, and C‐IONM probe placement. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1568–E1574, 2016