Role of intraoperative neuromonitoring of the recurrent laryngeal nerve in high-risk thyroid surgery
Atallah, I.; Dupret, A.às.; Carpentier, A.-S.; Weingertner, A.S.; Volkmar, P.-P.; Rodier, J.-F.ço.
Journal of Otolaryngology - Head and Neck Surgery 38(6): 613-618
2009
ISSN/ISBN: 1916-0216 PMID: 19958722 Document Number: 633062
Thyroid surgeries associated with an elevated incidence of recurrent laryngeal nerve (RLN) injury are considered high-risk thyroidectomies. These high-risk operations include surgery for thyroid cancer, Graves disease, and recurrent goitre. In addition, the size of the goitre is an important risk factor for RLN injury. In our retrospective study, we tried to evaluate the role of intraoperative neuromonitoring of RLN specifically in high-risk thyroid surgery with 421 nerves at risk. Thyroid surgeries in our study were done by experienced surgeons in a high-volume provider centre.The overall percentage of RLN injury was 8.8% in the monitored group in comparison with 9.1% in the unmonitored group. The percentage of permanent nerve palsy in the monitored group was 3.9% of nerves at risk in comparison with 3.8% in the unmonitored group. No statistically significant difference was found between groups. Routine visual identification of the nerve by meticulous dissection is the best method to avoid RLN injury. The benefit of RLN neuromonitoring could be further assessed by performing a multicentre prospective study to compare the role of RLN neuromonitoring in high-risk thyroid surgeries.