Contralateral R1 and R2 components of the laryngeal adductor reflex in humans under general anesthesia.

Objectives: To demonstrate that under total intravenous general anesthesia (TIVA), the contralateral R1 (cRI) and contralateral R2 (cR2) components of the laryngeal adductor reflex (LAR) can be reliably elicited; to determine effects of topical anesthesia and inhalational anesthesia on the LAR; and to discuss how this technique may be utilized to continuously monitor the vagus nerve reflex arc.

Study Design: Case series.

Methods: Vocal fold mucosa was electrically stimulated via endotracheal tube surface-based electrodes to elicit a LAR.

A novel methodology for assessing laryngeal and vagus nerve integrity in patients under general anesthesia.

Objective: To describe a novel methodology for intraoperative neuro-monitoring of laryngeal and vagus nerves by utilizing the laryngeal adductor reflex (LAR).

Methods: Case series of 15 patients undergoing thyroid and cervical spine surgeries under total intravenous general anesthesia. Vocal fold mucosa was electrically stimulated to elicit a LAR using endotracheal tube based electrodes.