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Updated: Sep 27, 2025
Intra-Operative Neural Monitoring of Thyroid Surgery in a Porcine Model
Published on: February 11, 2019
Intraoperative recurrent laryngeal nerve monitoring versus visualisation alone - A systematic review and
Matthew G Davey1, Eoin F Cleere1, Aoife J Lowery1
1Discipline of Surgery, The Lambe Institute for Translational Research, National University of Ireland, Galway, Galway, H91 YR71, Ireland.
Background:
Intraoperative nerve monitoring (IONM) is perceived to reduce recurrent laryngeal nerve injury (RLNI) compared to RLN visualisation alone (VA). We performed a meta-analysis of randomized controlled trials (RCTs) to establish the value of using IONM instead of RLN VA for patients undergoing thyroidectomy.
Methods:
A meta-analysis of RCTs was performed as per PRISMA guidelines. RLNI rates were expressed as dichotomous variables and pooled as odds ratios (OR) and associated 95% confidence intervals (CI) using the Mantel-Haenszel method.
Results:
Eight RCTs with 2521 patients with 4977 nerves at risk were included. Overall, 49.8% of RLNs underwent IONM (2480/4978) and 50.2% underwent VA (2497/4978). Overall RLNI rates were higher for VA (VA: 3.2% (80/2497) vs. IONM: 2.3% (58/2480), OR: 0.72, 95% CI: 0.51-1.02, P = 0.060, I2 = 9%). Permanent RLNI rates were slightly higher for VA (VA: 0.6%, (12/2497) vs. IONM: 0.5%, (12/2480), OR: 0.76, 95% CI: 0.36-1.59, P = 0.470, I2 = 0%).
Conclusion:
When compared to VA alone, using IONM failed to significantly reduce RLNI rates during thyroid surgery.
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