American Association of Endocrine SurgeonsThe role of intraoperative neuromonitoring of recurrent laryngeal nerve during thyroidectomy: A comparative study on 1000 nerves at risk
Section snippets
Patients and methods
Between January 2002 and August 2005, the cases of 639 of 647 consecutive patients who underwent thyroidectomy by a single surgical team were evaluated; the cases of patients with an intraoperative finding of tumor involvement of RLN (n = 8) were excluded. IONM was performed for 316 patients on the basis of the availability of the equipment and the choice of the operating surgeons (neuromonitoring group); 323 patients underwent thyroidectomies with routine identification of RLN only (control
Results
There were 133 men and 506 women with a mean age of 49 years (range, 8-93 years). The operative procedures included total or near-total thyroidectomy (n = 358 patients), unilateral lobectomy (n = 241 patients), completion total thyroidectomy (n = 36 patients), and subtotal thyroidectomy (n = 4 patients). Unilateral and bilateral procedures were performed in 277 and 362 patients, respectively, which accounted for 1000 nerves that were at risk after the exclusion of the RLN injured patients
Discussion
Despite being described for >3 decades,11, 12 IONM of RLN with electrical stimulation during thyroid surgical procedures has not gained widespread popularity until recently4, 8, 9, 10, 13, 14, 15, 16 because of the availability of a more user-friendly system and the demand of applying new surgical technology. Nerve monitoring has been developed to facilitate the identification of RLN, to map its contour, to avoid its iatrogenic injury, and to obtain prognostic information about postoperative
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