Related Experiment Videos
[Neurostimulation of the recurrent laryngeal nerve--a routine method in thyroid gland surgery?]
K M Schulte1, K Cupisti, H D Röher
1Klinik für Allgemein- und Unfallchirurgie, Universitätsklinikum Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf.
Introduction:
Thyroid operations belong to the most frequent procedures in Germany (100,000/year). An important quality parameter is the incidence of postoperative recurrent nerve paralysis. Intraoperative identification by visualization of the nerve with a paralysis rate of 1% is the present gold standard in dedicated centers.
Problem:
Can this results be further improved by use of an intraoperative neuromonitoring system (NM).
Results:
The use of NM is helpful in difficult situations (recurrent goiter, advanced carcinoma, anatomic variants), but a quality improvement is not yet proven.
Conclusion:
NM can not replace the current nerve identification by meticulous preparation of anatomic structures. It should be used at the discretion of the operative surgeon.