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Role of intraoperative neuromonitoring of recurrent laryngeal nerves in the outcomes of surgery for thyroid cancer.
- Source :
-
International journal of surgery (London, England) [Int J Surg] 2014; Vol. 12 Suppl 1, pp. S213-7. Date of Electronic Publication: 2014 May 23. - Publication Year :
- 2014
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Abstract
- Introduction: The aim of this retrospective study was to evaluate the ability of intraoperative neuromonitoring to predict the postoperative functional outcome and its role in reducing the postoperative recurrent laryngeal nerve palsy rate during thyroidectomy for thyroid malignancy.<br />Methods: Between June 2007 and March 2013, 656 consecutive patients with thyroid cancer underwent thyroidectomy by a single surgical team. We compared 357 patients who have had neuromonitoring (Group A) to 299 patients who have undergone surgery with nerve visualization alone (group B).<br />Results: In group A 7 recurrent laryngeal nerve paralysis were observed (1.96%), 6 (1.68%) transient and 1 (0.28%) permanent; a bilateral recurrent laryngeal palsy was observed in 1 of the 7 cases (0.28%). In group B 6 recurrent laryngeal nerve paralysis were observed (2.01%), 5 (2.01%) transient and 1 permanent (0.33%); bilateral palsy was observed in 1 of the 6 cases (0.33%). Differences were not statistically significative.<br />Conclusions: Routine visual nerve identification remains the gold standard of recurrent laryngeal nerve management in surgery for thyroid cancer. Intraoperative neuromonitoring is safe, effective, reliable, and easy to perform in excluding postoperative recurrent laryngeal palsy. It helps to identify the nerve in thyroid cancer, but it did not decrease the injuries compared with visualization alone in this study; however, its use can change the operative strategy in order to prevent the risk of bilateral damage in case of signal loss. Future studies are needed to evaluate the benefit of intraoperative neuromonitoring in thyroidectomy for thyroid cancer.<br /> (Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Female
Humans
Male
Middle Aged
Recurrent Laryngeal Nerve Injuries physiopathology
Retrospective Studies
Thyroid Neoplasms surgery
Thyroidectomy adverse effects
Young Adult
Intraoperative Complications prevention & control
Intraoperative Neurophysiological Monitoring methods
Recurrent Laryngeal Nerve physiopathology
Recurrent Laryngeal Nerve Injuries prevention & control
Thyroidectomy methods
Subjects
Details
- Language :
- English
- ISSN :
- 1743-9159
- Volume :
- 12 Suppl 1
- Database :
- MEDLINE
- Journal :
- International journal of surgery (London, England)
- Publication Type :
- Academic Journal
- Accession number :
- 24862668
- Full Text :
- https://doi.org/10.1016/j.ijsu.2014.05.003