Detection of increased intracranial pressure in trans-oral robotic thyroidectomy using optic nerve sheath diameter measurement
- Authors
- Lim, Hyunyoung; Kim, Eugene; Kim, Soo Yeon; Kim, Ji-Yoon; Jung, Yundo; Lee, Tagkeun; Kim, Nayeon; Tae, Kyung
- Issue Date
- Feb-2023
- Publisher
- WILEY
- Keywords
- CO2 insufflation; intracranial pressure; optic nerve sheath diameter; trans-oral robotic thyroidectomy
- Citation
- HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, v.45, no.2, pp.329 - 336
- Indexed
- SCIE
SCOPUS
- Journal Title
- HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
- Volume
- 45
- Number
- 2
- Start Page
- 329
- End Page
- 336
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/185229
- DOI
- 10.1002/hed.27234
- ISSN
- 1043-3074
- Abstract
- Background During transoral robot-assisted thyroidectomy, there is a risk of increasing intracranial pressure because the site of CO2 insufflation is narrow and close to the brain. Methods We analyzed the pre- to post-CO2 neck insufflation change in the optic nerve sheath diameter during transoral robot-assisted thyroidectomy. Changes in vital-signs, airway pressure, and arterial carbon dioxide pressure were analyzed along with postoperative complications. Results Among the 30 participants, the post-CO2 inflation mean optic nerve sheath diameter (5.64 +/- 0.54 mm) was higher than the pre-induction diameter (4.81 +/- 0.37 mm) with a mean difference of 0.83 (95% CI, 0.69-0.97; p < 0.001), but returned to baseline after CO2 deflation in most cases. One participant had sustained increased optic nerve sheath diameter (6.35 mm) associated with severe new-onset postoperative headache. Conclusion Transient elevation in the intracranial pressure during low-pressure CO2 neck insufflation in the transoral robot-assisted thyroidectomy did not appear to adversely affect patients.
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