Related Experiment Video
Updated: Jun 30, 2026
05:25
Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
Published on: October 24, 2025
Neuromonitoring and video-assisted thyroidectomy: a prospective, randomized case-control evaluation.
Gianlorenzo Dionigi1, Luigi Boni, Francesca Rovera
1Department of Surgical Sciences, Endocrine Surgery Research Center, University of Insubria, Varese, Italy. gianlorenzo.dionigi@uninsubria.it
Surgical Endoscopy
|September 23, 2008
Summary
Intraoperative neuromonitoring (IONM) improves recurrent laryngeal nerve identification during video-assisted thyroidectomy (VAT). While IONM enhances external branch of superior laryngeal nerve visualization, it did not reduce overall complication rates in this study.
Area of Science:
- Endocrine Surgery
- Surgical Neurology
Background:
- Video-assisted thyroidectomy (VAT) is a minimally invasive surgical technique.
- Accurate identification of laryngeal nerves is crucial during thyroid surgery to prevent injury.
Purpose of the Study:
- To evaluate the role of intraoperative neuromonitoring (IONM) in VAT.
- To assess IONM's effectiveness in identifying the recurrent laryngeal nerve (RLN) and external branch of the superior laryngeal nerve (EBSLN).
Main Methods:
- A prospective randomized trial involving 72 patients undergoing standard gasless VAT.
- Control group (N=36): nerve identification using endoscopic magnification only.
- IONM group (N=36): standard IONM technique including localization and monitoring of vagus, RLN, and EBSLN.
Main Results:
- No permanent complications occurred in either group.
- Temporary RLN injury rates were lower in the IONM group (2.7%) compared to the control group (8.3%).
- EBSLN identification was significantly better in the IONM group (83.6%) versus the control group (42%).
Conclusions:
- Standardized IONM is technically feasible and safe in selected VAT patients.
- IONM effectively identifies and monitors laryngeal nerve function during VAT.
- Further larger studies are required to confirm a reduction in postoperative complication rates.
