1 May 2015Article
Intraoperative nerve monitoring in thyroid surgery
Ayfer Polat 1Gokhan Lap 1Selcuk Ozbalci 1Kagan Karabulut 1Bulent Gungor 1Cafer Polat 1Kenan Erzurumlu 1
Affiliations
Article Info
1 General Surgery Department, University of Ondokuz Mayis, Samsun, Turkey
Ann. Ital. Chir., 2015, 86(3), 207-211;
Published: 1 May 2015
Copyright © 2015 Annali Italiani di Chirurgia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
BACKGROUND: Nerve injury is one of the specific complications of thyroid surgery despite many advances in surgical technique. The recurrent laryngeal nerve (RLN) and the external branch of superior laryngeal nerve are the nerves at risk during thyroid surgery (1). Morbidity related to recurrent laryngeal nerve injury varies from changes in voice quality to severe dyspnea requiring tracheal intubation or tracheostomy. To minimize the risk of nerve injury, intraoperative nerve monitoring (IONM) being suggested as a tool for helping visual control for RLN has gained significant interest in recent years (1,2). We aimed to determine the effectiveness of nerve monitoring during thyroid surgery and to provide a clinical experience. MATERIALS AND METHODS: This study was performed from June 2010 to June 2012. We prospectively evaluated 94 patients who had thyroid surgery with or without nerve monitoring. Of those patients 48 were in monitored group (M) and 46 were in unmonitored group (UM). RESULTS: The mean age was 48 (27-76) in M group and 52 (73-17) in UM. There was only one patient had transient hoarseness in M group and also one patient had transient hoarseness in UM group. One each in both groups had persistent hoarseness. No patients experienced airway problem. Operation time was significantly shorter in M group (p<0.001). CONCLUSIONS: Use of a nerve monitoring system does not substitute for careful dissection and visual identification of nerves, but monitoring can assist the surgeon in identifying the RLN anatomic variability and may decrease the operation time during thyroid surgery.
Keywords
- Complications
- Injuries
- Nerve monitoring injury
- Operation time
- Thyroid
- surgery