Utility of Intraoperative Neurophysiological Monitoring in Thyroid Surgeries
DOI:
https://doi.org/10.5281/zenodo.10214449Keywords:
vagus nerve, RLN, SLN, recurrent laryngeal nerve, superior laryngeal nerve, EMG, CoMEP, Corticobulbar MEP, ThyroidAbstract
With the ultimate objective of reducing nerve injury, considering the uniqueness of each surgery to accommodate the patient best relies heavily on the intricacies presented within the surgery coupled with an understanding of when and how to implement monitoring. Thyroid and parathyroid surgeries present significant risks to patient outcomes, with the most frequent postoperative deficits resulting from injury to the vagal nerve and the recurrent laryngeal nerve (RLN). While visual identification has historically been used, the potential of permanent vocal cord damage necessitates new methods. As these nerves are particularly susceptible to insult during these procedures, we sought to establish the connection between IONM and analyze the role it plays in the reduction of these deficits.
Advantages alongside limitations of IONM were considered as we compared the success rates of nerve function retention and instances in which it was reported that monitoring did not produce ideal outcomes. The implications of these findings suggest that IONM aids in the early determination of damage, allowing clinicians the opportunity to make revisions that prevent loss and best preserve the integrity of nerves following procedures. Proper application of developing protocols should influence physicians' decisions of utilizing IONM techniques in the most advantageous way to the case, amending surgical strategy when needed.
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