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Intra-Operative Neural Monitoring of Thyroid Surgery in a Porcine Model
Published on: February 11, 2019
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Thyroid reoperation using intraoperative neuromonitoring.
Beata Wojtczak1, Krzysztof Sutkowski2, Krzysztof Kaliszewski2
1Department and Clinic of General, Gastroenterological and Endocrine Surgery, Wroclaw Medical University, Wroclaw, Poland. beatawojtczak@wp.pl.
Endocrine
|October 21, 2017
Summary
Intraoperative neuromonitoring (IONM) significantly improves recurrent laryngeal nerve (RLN) identification during thyroid reoperations. This enhanced identification aids in minimizing RLN injury and allows for more radical resection.
Area of Science:
- Endocrinology
- Surgical Oncology
- Neurosurgery
Background:
- Thyroid reoperations carry a high risk of recurrent laryngeal nerve (RLN) injury.
- Accurate identification of the RLN is crucial for preserving vocal cord function post-thyroidectomy.
Purpose of the Study:
- To evaluate the efficacy of intraoperative neuromonitoring (IONM) in identifying the RLN during thyroid reoperations.
- To compare the rates of RLN injury and extent of resection between IONM-assisted and visually identified RLN procedures.
Main Methods:
- Retrospective cohort study of 61 patients undergoing thyroid reoperation.
- Comparison of RLN identification rates, injury prevalence, and thyroidectomy extent between groups with and without IONM.
Main Results:
- IONM significantly increased RLN identification rates (91.6%) compared to visual identification (44.4%).
- Permanent RLN paresis occurred in 6.6% with visual identification versus 0% with IONM.
- IONM was associated with a significantly higher rate of total or near-total thyroidectomies (94% vs. 71%).
Conclusions:
- Intraoperative neuromonitoring (IONM) is recommended for thyroid reoperations.
- IONM enhances RLN identification, reduces injury risk, and facilitates more extensive thyroid tissue resection.
