J Endocr Surg.  2018 Mar;18(1):61-78. 10.16956/jes.2018.18.1.61.

Technical Instructions for Continuous Intraoperative Neural Monitoring in Thyroid Surgery

• Kim HY
• Chai YJ
• Barczynski M
• Makay O
• Wu CW
• Rizzo AG
• Bartolo V
• Sun H
• Dionigi G
• the Korean Intraoperative Neural Monitoring Society (KINMoS)

• KMID: 2414423
• DOI: http://doi.org/10.16956/jes.2018.18.1.61

Abstract

One of the most significant advancements in neural monitoring for thyroid surgery is currently the permanent recording of the vagus nerve (VN) in order to prevent intraoperatively recurrent laryngeal nerve (RLN) iatrogenic injuries. Continuous intraoperative neuromonitoring (CIONM) seems to be superior to intermitted intraoperative neural monitoring (I-IONM) because it enhances standardization, and it provides entire and constant RLN function surveillance as the surgeon dissects the thyroid gland. It also has to be highlighted that the surgical maneuvers for the CIONM probe placement must be accurate in order to avoid a potential iatrogenic morbidity on the VN function. With this review article the Korean Intraoperative Neural Monitoring Society (KINMoS) provides a comprehensive analyses of CIONM technique.

Keyword

Thyroid; Surgery; Neural monitoring; Morbidity

MeSH Terms

Recurrent Laryngeal Nerve
Thyroid Gland*
Vagus Nerve

Figure

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  Fig. 1. Ultrasonography showed multiple nodules that ranged from 1.0 to 4.7 cm at their longest diameters.

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  Fig. 2. CT revealed a bulky, 17×8×6 cm thyroid gland that extended to the thoracic cavity: (A) coronal view, (B) sagittal view. CT = computed tomography.

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  Fig. 3. Surgical specimen was obtained after total thyroidectomy via median sternotomy.

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  Fig. 4. No vocal cord dysfunction was found in the laryngoscopic evaluation after the surgery: (A) phonation, (B) inspiration.

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