J Endocr Surg.  2017 Sep;17(3):96-103. 10.16956/jes.2017.17.3.96.

Future Directions of Neural Monitoring in Thyroid Surgery

Affiliations
  • 1Korea University Medical Center (KUMC) Thyroid Center, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
  • 2Division of Thyroid Surgery, Jilin Provincial Key Laboratory of Surgical Translational Medicine, China-Japan Union Hospital of Jilin University, Changchun, China.
  • 3Department of Otolaryngology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
  • 4Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
  • 51st Division of General Surgery, Research Center for Endocrine Surgery, Department of Medicine and Surgery, ASST dei Sette Laghi Ospedale di Circolo e Fondazione Macchi, Polo Universitario, University of Insubria (Varese-Como), Varese, Italy. gdionigi@unime.it

Abstract

Dissecting and identifying the recurrent laryngeal nerve (RLN) are considered routine procedures now that safe and effective methods have been established. Preventing RLN injury during thyroid surgery requires good visualization and exposure of the RLN, adequate knowledge of RLN anatomy, adequate surgical experience and training, and pre- and post-operative laryngoscopy. Whereas these requirements are widely accepted for routine thyroid surgery, new technical developments have emerged in the past 15 years. Literature show that both intermittent intraoperative neural monitoring (I-IONM) and continuous IONM (C-IONM) are recognized as effective techniques for RLN. The aim of this paper is to discuss advantages, limits and possible future directions for use of IONM and C-IONM in thyroid and parathyroid surgery.

Keyword

Thyroid gland; Recurrent laryngeal nerve; Intraoperative neurophysiological monitoring; Endoscopic; Thyroidectomy; Standards

MeSH Terms

Intraoperative Neurophysiological Monitoring
Laryngoscopy
Recurrent Laryngeal Nerve
Thyroid Gland*
Thyroidectomy

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