Identification alone versus intraoperative neuromonitoring of the recurrent laryngeal nerve during thyroid surgery: experience of 2034 consecutive patients

Journal of Otolaryngology-Head & Neck Surgery

Angelo Nicolosi²  Roberto Demontis³  Luca Gordini²  Maria Rita Pittau¹  Fabio Medas²  Giuseppe Pisano²  Pietro Giorgio Calò² 

[1] School of Specialty in Forensic Medicine, University of Cagliari, Cagliari, Italy;Department of Surgical Sciences, University of Cagliari, Cagliari, Italy;Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy

关键词: Thyroidectomy;    Recurrent laryngeal nerve;    Neuromonitoring;   

Others  :  861344
DOI  :  10.1186/1916-0216-43-16

 received in 2013-12-26, accepted in 2014-06-11,  发布年份 2014

【 摘 要 】

Background

The aim of this study was to evaluate the ability of intraoperative neuromonitoring in reducing the postoperative recurrent laryngeal nerve palsy rate by a comparison between patients submitted to thyroidectomy with intraoperative neuromonitoring and with routine identification alone.

Methods

Between June 2007 and December 2012, 2034 consecutive patients underwent thyroidectomy by a single surgical team. We compared patients who have had neuromonitoring and patients who have undergone surgery with nerve visualization alone. Patients in which neuromonitoring was not utilized (Group A) were 993, patients in which was utilized (group B) were 1041.

Results

In group A 28 recurrent laryngeal nerve injuries were observed (2.82%), 21 (2.11%) transient and 7 (0.7%) permanent. In group B 23 recurrent laryngeal nerve injuries were observed (2.21%), in 17 cases (1.63%) transient and in 6 (0.58%) permanent. Differences were not statistically significative.

Conclusions

Visual nerve identification remains the gold standard of recurrent laryngeal nerve management in thyroid surgery. Neuromonitoring helps to identify the nerve, in particular in difficult cases, but it did not decrease nerve injuries compared with visualization alone. Future studies are warranted to evaluate the benefit of intraoperative neuromonitoring in thyroidectomy, especially in conditions in which the recurrent nerve is at high risk of injury.

【 授权许可】

   
2014 Calò et al.; licensee BioMed Central Ltd.

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