Related Nerve Monitoring Products
Our nerve monitoring products and accessories that can be used in conjunction with NIM® Nerve Monitoring Systems during a variety of surgical procedures. These include ENT surgeries, such as otologic procedures and thyroidectomies, as well as other operations performed by endocrine, general, and peripheral surgeons.
NIM EMG Endotracheal Tubes
NIM TriVantage Tube with cross-band to guide placement
Why Use a NIM EMG Tube?
Even experienced surgeons find it difficult to visually identify the recurrent laryngeal nerve (RLN) or vagus nerve during thyroid surgery and other neck dissections. Studies show that the rate of RLN injury is under-estimated1-6 and intraoperative nerve monitoring of the RLN is recommended as a risk-minimizing tool.1-4,7-15
NIM® EMG Tubes provide an open airway for patient ventilation and intraoperative nerve monitoring of both vocal cords. If nerve function changes, the NIM System alerts you with visual and audible warnings to help reduce the risk of patient injury.
NIM TriVantage EMG Tube
The NIM TriVantage™ EMG Tube is a standard size, non-reinforced, DEHP-free PVC tube that features smooth, conductive silver ink electrodes and a cross-band to guide placement. It has reduced sensitivity to rotation and movement while offering increased EMG responses that facilitate improved nerve dissection.
Together with the NIM System, a properly positioned NIM EMG Tube can reduce the risk of injury to your patient by helping you to:
- Identify the recurrent laryngeal or vagus nerves
- Control manipulation during dissection
- Verify the integrity of the nerve prior to surgical closure
Only NIM EMG Tubes are tested and validated for use with NIM nerve monitors.
Surgical Applications for NIM EMG Endotracheal Tubes
- Carotid endarterectomy
- Cricopharyngeal myotomy
- Excision of Zenker’s diverticulum
- Hemithyroidectomy
- Neck biopsy
- Neck dissection
- Parathyroidectomy
- Partial laryngectomy
- Substernal goiter
- Thyroidectomy
References
- Lo C, Kwok F, Yuen P. A prospective evaluation of recurrent laryngeal nerve paralysis during thyroidectomy. Archives of Surgery 2000;135(2): 204-207.
- Dionigi G, et al. The technique of intraoperative neuromonitoring in thyroid surgery. Surg Technol Int. 2010;19: 25-37.
- Dionigi G, et al. Why monitor the recurrent laryngeal nerve in thyroid surgery? J Endocrinal Invest. 2010; 33: 819-822.
- Randolph GW. Surgery of the Thyroid and Parathyroid Glands. Chapter 25: Surgical Anatomy of the Recurrent Laryngeal Nerve (p316). Elsevier Science (USA), 2003.
- Bergenfelz A, Jansson S, Kristoffersson A. Complications of thyroid surgery: results as reported in a database from a multicenter audit comprising 3,660 patients. Langenbecks Arch Surg. 2008; 393: 667-673.
- Ready AR, Barnes AD. Complications of thyroidectomy. Br J Surg. 1994; 81: 1555-1556.
- Randolph GW and Dralle H with the International Intraoperative Monitoring Study Group. Electrophysiologic recurrent laryngeal nerve monitoring during thyroid and parathyroid surgery: international standards guideline statement. Laryngoscope 2011; 121:S1-S16.
- Dralle H. Intraoperative monitoring of the recurrent laryngeal nerve in thyroid surgery. World J Surg. 2008 32(7): 1358-1366. This article received the World Journal of Surgery award for Best Paper in 2008 and identifies risk-minimizing tools to help avoid recurrent laryngeal nerve palsy.
- Thomusch O, Sekulla C, Walls G, Machens A, Dralle H. Intraoperative neuromonitoring of surgery for benign goiter. Amer J Surg. 2002;183(6): 673–678.
- Dralle H, Sekulla C, Haerting J, Timmermann W, Neumann HJ, Kruse E, Grond S, Mühlig HP, Richter C, Voß J, Thomusch O, Lippert H, Gastinger I, Brauckhoff M , Gimm O. Risk factors of paralysis and functional outcome after recurrent laryngeal nerve monitoring in thyroid surgery. Surgery. 2004;136:1310–1322.
- Eisele DW. Intraoperative electrophysiologic monitoring of the recurrent laryngeal nerve. Laryngoscope. 1996;106: 443–449.
- Chiang F-Y, Lu I-C, Chen H-C, Chen H-Y, Tsai C-J, Hsiao P-J, Lee K-W, Wu C-W. Anatomical variations of recurrent laryngeal nerve during thyroid surgery; how to identify and handle the variations with intraoperative neuromonitoring. Kaohsiung J Med Sci. 2010; 26(11): 575-583.
- Chiang FY, et al. Intraoperative neuromonitoring for early localization and identification of recurrent laryngeal nerve during thyroid surgery. Kaohsiung J Med Sci. 2010; 26(12): 633-638.
- Chiang FY, et al. Standardization of intraoperative neuromonitoring of recurrently laryngeal nerve in thyroid operation. World J Surg 2010; 34(2): 223-229.
- Dralle H, et al. What benefits does neuromonitoring bring to thyroid surgery? Artz und Krankenhaus. 2004; 369-376.
Electrodes, Probes, and Other Nerve Monitoring Accessories
Nerve Monitoring Accessories for the NIM Systems
We offer a complete line of instruments and accessories for our NIM® Nerve Monitoring Systems. They include:
- Monopolar and bipolar probes
- Incrementing Probe that allows you to adjust stimulus levels from the surgical field
- Muscle-specific, color-coded electrodes
- EMG endotracheal tubes
- Stimulus-dissection instruments
- Surgeon Mini-Screen that attaches to any I.V. pole
- APS® (Automatic Periodic Stimulation) Electrode that provides real-time, continuous monitoring*
- Stim Bur technology that provides advance warning of facial nerve proximity**
With more than 20 years of nerve monitoring experience, our instruments and accessories help make nerve monitoring easier and more accurate.
See our complete line of intraoperative nerve monitoring accessories in our ENT Product Catalog.
* For use with NIM-Response 3.0 and NIM-Neuro 3.0 models only.
** Nerve monitoring capability provided by NIM-Response or NIM-Neuro Nerve Monitoring Systems, models 2.0 and later. Must be used with Visao High-Speed Otologic Drill and IPC System.
Stim Bur Guard for Otologic Procedures
Stim Bur Guard for integrated nerve monitoring during otologic procedures with the Visao Otologic Drill and NIM Nerve Monitoring System*
Integrated Facial Nerve Monitoring
The innovative Stim Bur Guard for the Visao® High-Speed Otologic Drill is the first and only commercially available surgical tool that combines an electric drill with stimulation for nerve monitoring. It works with our NIM® Nerve Monitoring System to alert you of the bur’s proximity to the facial nerve and help reduce the risk of patient injury during otologic procedures.*
The Stim Bur Guard provides stimulating current to our otologic burs in both static and dynamic modes. Stimulating the nerve while the bur is in use can offer approximately 1-3 mm of advance warning of facial nerve proximity. If nerve function changes, the NIM system provides visual and audible warnings to alert you.
You can use the Stim Bur Guard with or without irrigation, and numerous bur types are available. See the ENT Product Catalog for a complete selection of our otologic burs.
*Nerve monitoring capability provided by NIM-Response® or NIM-Neuro® Nerve Monitoring Systems, models 2.0 and later. Must be used with Visao® High-Speed Otologic Drill and Integrated Power Console (IPC®) System.
About the MicroFrance Terris Thyroidectomy Instruments
MicroFrance Terris Thyroidectomy Instruments
MicroFrance Terris Malleable Nerve Suction for Thyroidectomies
MicroFrance Terris Peanut Holder for Thyroidectomies
The MicroFrance® line of precision ENT surgical instruments includes the Terris Thyroidectomy Instrument Set, developed in conjunction with David Terris, MD, FACS. It offers an innovative approach to address the unique challenges of thyroidectomies and provide maximum access, visibility, and precision. These instruments may be used for both conventional "open" and minimally invasive techniques.
The Terris Thyroidectomy Instrument Set includes:
- Angled, flared retractors that provide maximum access and visibility without interfering with the anterior chest wall
- Malleable suction elevator that enables tissue retraction and ultrasonic steam evacuation
- Malleable blunt tip suction that’s customizable for atraumatic suction around delicate nerves
- Low-profile elevators designed for precise dissection of the recurrent laryngeal nerve
- Slender peanut holder design that allows for unobtrusive blunt dissection; one-handed mechanism enables rapid loading and unloading
MicroFrance Premier Instrumentation
The MicroFrance® brand is a premier line of ENT instruments, designed with world-renowned ENT surgeons to facilitate new techniques and improve patient outcomes.
