[Intraoperative neuromonitoring in thyroid surgery].

Area of Science:

• Endocrine Surgery
• Neurosurgery
• Surgical Innovation

Background:

• Thyroid surgery carries a risk of recurrent laryngeal nerve injury, potentially causing vocal cord paralysis.
• Systematic identification of the recurrent laryngeal nerve is crucial for anatomical landmarking in cervical endocrine surgery.

Purpose of the Study:

• To establish normal electrophysiological values for vagus and recurrent laryngeal nerves pre- and post-thyroid surgery.
• To evaluate the impact of intraoperative neuromonitoring on recurrent laryngeal nerve injury rates in thyroid surgery.

Main Methods:

• An observational, prospective study included 490 patients undergoing thyroid surgery.
• Recurrent laryngeal nerves were systematically identified in 411 patients (2003-2010).
• Intraoperative neuromonitoring was systematically applied to 79 patients (2010-2011).

Main Results:

• Prior to neuromonitoring, 14 of 704 nerves at risk sustained injury.
• Following the introduction of intraoperative neuromonitoring, no injuries occurred in 135 nerves at risk.

Conclusions:

• Systematic recurrent laryngeal nerve identification remains the gold standard in thyroid surgery.
• Intraoperative neuromonitoring serves as a valuable adjunct, enhancing surgical safety.
• The combination of techniques optimizes outcomes in cervical endocrine surgery.