[Intraoperative neuromonitoring during endocrine surgery]

Area of Science:

• Otolaryngology
• Surgical Innovation
• Nerve Monitoring

Context:

• Thyroid surgery poses risks of recurrent laryngeal nerve (RLN) injury, particularly during reoperations or malignancy resections.
• Traditional RLN identification is the standard for preventing nerve damage.
• Altered anatomy in reoperative cases increases the risk of inadvertent RLN injury.

Purpose:

• To introduce and evaluate a novel technique for intraoperative testing of recurrent laryngeal nerve (RLN) function.
• To assess the efficacy of intraoperative neuromonitoring in preventing RLN injury and vocal cord palsy.
• To explore the utility of objective intraoperative measurements in managing postoperative voice symptoms.

Summary:

• Intraoperative neuromonitoring allows for real-time assessment of recurrent laryngeal nerve (RLN) function during thyroid surgery.
• The technique demonstrates high specificity and negative predictive value, confirming intact nerve function with unchanged signals.
• It is particularly valuable in reoperative settings with altered anatomy, aiding RLN identification and preventing bilateral vocal cord palsy.

Impact:

• Reduces the incidence of recurrent laryngeal nerve (RLN) injury and associated vocal cord paralysis after thyroidectomy.
• Provides objective data to support clinical decision-making and patient prognosis regarding voice function.
• Enhances surgical safety in complex thyroid procedures, including reoperations and cancer resections.