Method and apparatus for connection of stimulus and recording electrodes of a multi-channel nerve integrity monitoring system

摘要

The invention provides a method and apparatus for connecting multiple electrodes into the receiving or head box portion of the nerve integrity monitor. The invention may provide patient connection electrodes, their transmission lines and a manner by which these components may communicate to the main monitoring unit to actuate automatic setup functions and instructions. The off-line setup and diagnostic instructions may be automatically initiated and annunciated to the main portion of the intraoperative nerve integrity monitor. The setup and diagnostic instructions may then automatically executed. The invention also may provide patient connection electrodes with improved resistance to the deleterious effects of spurious electromagnetic artifacts. The invention may also include the incorporation of both stimulation and recording electrodes with a single cable, but with the head boxes for recording and stimulation arranged in a staggered fashion along that cable. The recording electrode portion may appear at the terminal end of the cable and can be placed at the site of recording electrode placement. This arrangement allows use of shorter length electrodes, which may be cheaper to construct and less susceptible to electromagnetic and mechanical (drape movement) artifacts. The stimulus portion may be positioned more proximate to the main unit by several feet. After the recording portion is properly positioned, the stimulus connection box may be approximately at its optimal positioning for access after surgical draping. The all-in-one construction would obviate the need to separately place a stimulus head box apparatus, as for devices that include separate recording and stimulation head boxes and associated cabling. The invention may be particularly applicable for use in monitoring facial electromyograhic (EMG) activity during surgeries in which a facial motor nerve is at risk due to unintentional manipulation, as well as for other neural monitoring procedures.