Usefulness of neuromonitoring in thyroid surgery

Area of Science:

• Surgical techniques
• Nerve monitoring
• Endocrine surgery

Background:

• Identifying the recurrent laryngeal nerve (RLN) is crucial for preventing nerve injury during thyroidectomy.
• Visual identification alone has limitations in definitively locating the RLN.

Purpose of the Study:

• To assess the efficacy of neuromonitoring in identifying the RLN during thyroidectomy.
• To compare the outcomes of thyroidectomy performed with and without neuromonitoring.

Main Methods:

• A comparative study involving 259 recurrent laryngeal nerves at risk during thyroidectomy.
• Group A (129 nerves) underwent surgery with neuromonitoring; Group B (130 nerves) served as the control without neuromonitoring.

Main Results:

• The percentage of visually unidentified nerves was similar between groups (18% vs. 20%).
• Neuromonitoring achieved 100% identification of previously unidentified nerves, a statistically significant improvement.
• Neuromonitoring demonstrated 100% positive and negative predictive value.

Conclusions:

• Neuromonitoring enhances recurrent laryngeal nerve identification accuracy in thyroidectomy.
• The use of neuromonitoring increases surgeon confidence and procedural safety.
• Routine implementation of neuromonitoring in thyroid surgery is advised.