Intraoperative Neuromonitoring Systems
Intraoperative Neuromonitoring Systems
NIM™ intraoperative neuromonitoring systems enable surgeons to identify, confirm, and monitor motor nerve function to help reduce the risk of nerve damage1,2 during various procedures, including ENT and general surgeries.
NIM™ 3.0 Nerve Monitors
Based on more than 20 years of experience, the NIM-Response™ 3.0 and NIM-Neuro™ 3.0 nerve monitoring systems offer nerve monitoring technology. NIM™ systems monitor EMG activity from multiple muscles. If there is a change in nerve function, the NIM™ system may provide audible and visual warnings to help reduce the risk of nerve damage.1,2
Our NIM™ 3.0 systems feature a touch screen with three simple user modes, and default or customer settings. They also offer:
Upon installation of our NIM™ intraoperative neuromonitoring system, we provide thorough on-site training for you and your staff, as well as ongoing service and training as needed — including a technical support help line.
Our NIM™ intraoperative neuromonitoring systems is an electromyographic (EMG) monitor for use during various surgeries, including ENT and general surgical procedures in which a nerve may be at risk due to unintentional manipulation. NIM™ nerve monitoring electrodes are placed in the appropriate muscle locations in the patient for the procedure being performed. (Color-coded placement guides are included in the NIM software.)
These electrodes are connected to the NIM™ systems, which monitors EMG activity from muscles innervated by the affected nerve. When a particular nerve has been activated or stimulated, the NIM™ system warns the surgeon and operating room staff, providing both visual alerts on the color touchscreen monitor and audio feedback to help minimize trauma to the nerve.3
Surgeons can use monopolar and bipolar stimulating probes and dissection instruments with the NIM™ system to assist in early nerve identification and confirmation. These tools may be used to locate, identify, and map the particular nerve and branches, as well as verify nerve function and integrity.
By combining sophisticated hardware electronics and intuitive software, our NIM™ intraoperative neuromonitoring systems help surgeons perform critical procedures while preserving nerve function1,2 and helping to maintain patient quality of life.4
Why Nerve Monitoring Is Needed
Even with a detailed knowledge of anatomy and surgical skill, motor nerves can sometimes be difficult to identify during surgery due to disease, a previous operation, or normal anatomical variations.5
Patients can suffer temporary or permanent damage if a nerve is irritated or injured. For example, during skull-based surgery, the facial nerve is commonly exposed and at risk for injury. Since this nerve controls all movements and expressions of the face, damaging this nerve can have devastating physical and emotional results.
Sometimes minor irritation or stretching of the facial nerve can lead to temporary or permanent symptoms of nerve damage, such as facial weakness, numbness, or twitching. Severing the facial nerve, although rare, causes facial paralysis that resembles the effects of a stroke.
Similarly, the recurrent laryngeal nerve, a branch of the vagus nerve, is one of the nerves at risk during neck dissections, including thyroid surgery. Damaging this nerve can severely affect an individual’s ability to speak, swallow, and aspirate. Clinical evidence demonstrates the benefits of intraoperative nerve monitoring for nerve preservation and as a risk-minimizing tool.6
Medtronic’s NIM™ systems help surgeons locate and identify the nerve, monitor and control manipulation effects on the nerve, and confirm nerve integrity prior to completing the surgery.6 Patients can learn more about thyroid surgery and nerve monitoring in our patient information section.
Thomusch O, Sekulla C. Intraoperative neuromonitoring of surgery for benign goiter. The American Journal of Surgery 183 (2002) 673–678
Vasileiadis I, Theodore Karatzas T. Association of intraoperative neuromonitoring with reduced recurrent laryngeal nerve injury in patients undergoing total thyroidectomy. JAMA Otolaryngology–Head & Neck Surgery October 2016 Volume 142, Number 10
Dionigi G, et al. Why monitor the recurrent laryngeal nerve in thyroid surgery? J Endocrinal Invest. 2010;33:819-822
Wilson JA, Deary IJ, Miller A, et al. The quality of life impact of dysphonia.Clin Otolaryng 2002;27:179-82
Chiang FY, et al. 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.
Dralle H, C. Sekulla K. Intraoperative Monitoring of the Recurrent Laryngeal Nerve in Thyroid Surgery. World J Surg (2008) 32:1358–1366