The usefulness of intraoperative neurological monitoring for esophageal cancer with double aortic arch; a case report

Shu Mushiake, Kohei Taniguchi, Sang-Woong Lee, Tetsunosuke Shimizu, Yoshiro Imai, Ryo Tanaka, Kotaro Honda, Keitaro Tashiro, Masaru Kawai, Kazuhisa Uchiyama
2020 BMC Surgery  
Double aortic arch (DAA) is a congenital anomaly of the aorta. Esophageal cancer with DAA is rare, and consequently, the appropriate surgical approach has not been standardized. Herein, we report the utilization of intraoperative neurological monitoring (IONM) system to preserve the function of the recurrent laryngeal nerve. A 79-year-old man with esophageal cancer was diagnosed with DAA incidentally. The descending aorta was located on the right side of the thoracic vertebrae. Safe dissection
more » ... e. Safe dissection of the mediastinal lymph nodes was difficult using the right transthoracic approach because of the anatomical abnormalities. During surgery, we used cervical mediastinoscopy combined with the IONM system to preserve the bilateral recurrent laryngeal nerves. Severe complications, including recurrent nerve palsy, were not observed postoperatively. IONM may be useful for evaluation of the function of the recurrent laryngeal nerve, and it would be suitable for atypical cases of esophageal cancer.
doi:10.1186/s12893-020-00751-6 pmid:32366237 fatcat:qay6zmvtuvgdnguki65yxyhcpq