International neural monitoring study group guideline 2018 part I: Staging bilateral thyroid surgery with monitoring loss of signal

Rick Schneider¹, Gregory W Randolph^{2

3}, Gianlorenzo Dionigi⁴, Che-Wei Wu⁵, Marcin Barczynski⁶, Feng-Yu Chiang⁵, Zaid Al-Quaryshi⁷, Peter Angelos⁸, Katrin Brauckhoff⁹, Claudio R Cernea¹⁰, John Chaplin¹¹, Jonathan Cheetham¹², Louise Davies¹³, Peter E Goretzki¹⁴, Dana Hartl¹⁵, Dipti Kamani², Emad Kandil¹⁶, Natalia Kyriazidis¹⁷, Whitney Liddy¹⁸, Lisa Orloff¹⁹, Joseph Scharpf²⁰, Jonathan Serpell^{21

22}, Jennifer J Shin²³, Catherine F Sinclair²⁴, Michael C Singer²⁵, Samuel K Snyder²⁶, Neil S Tolley²⁷, Sam Van Slycke²⁸, Erivelto Volpi²⁹, Ian Witterick³⁰, Richard J Wong³¹, Gayle Woodson³², Mark Zafereo³³, Henning Dralle³⁴

Affiliations

¹ Martin Luther University Halle-Wittenberg, Department of General, Visceral, and Vascular Surgery, Halle, Germany.
² Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Harvard Medical School, Boston, Massachusetts.
³ Division of Surgical Oncology, Endocrine Surgery Service, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
⁴ Division for Endocrine Surgery, at the Department of Human Pathology in Adulthood and Childhood "G. Barresi," University Hospital G. Martino, University of Messina, Italy.
⁵ Kaohsiung Medical University Hospital, Kaohsiung Medical University, Otolaryngology-Head and Neck Surgery, Kaohsiung, Taiwan.
⁶ Jagiellonian University, Department of Endocrine Surgery, Third Chair of General Surgery, Krakow, Poland.
⁷ University of Iowa Hospitals and Clinics, Otolaryngology, Iowa City, Iowa.
⁸ University of Chicago, Division of Endocrine Surgery, Department of Surgery, Chicago, Illinois.
⁹ Haukeland Universitetssjukehus, Department of Breast and Endocrine Surgery, Bergen, Norway.
¹⁰ University of Sao Paulo Medical School, Department of Head and Neck Surgery, Sao Paulo, SP, Brazil.
¹¹ Gillies Hospital & Clinics, Epsom, New Zealand.
¹² Cornell University, Clinical Sciences, College of Veterinary Medicine, Ithaca, New York.
¹³ VA Outcomes Group at the Veterans Affairs Medical Center, Norwich, Vermont.
¹⁴ Stadtische Kliniken Neuss Lukaskrankenhaus GmbH, Neuss, Nordrhein-Westfalen, Germany.
¹⁵ Institut Gustave Roussy, Otolaryngology Head & Neck Surgery, Villejuif, France.
¹⁶ Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
¹⁷ State University of New York Upstate Medical University, Otolaryngology, Syracuse, New York.
¹⁸ Northwestern University Feinberg School of Medicine Department of Psychiatry and Behavioral Sciences, Otolaryngology, Chicago, Illinois.
¹⁹ Stanford University School of Medicine, Otolaryngology, Division of Head and Neck Surgery, Stanford, California.
²⁰ Cleveland Clinic, Otolaryngology, Cleveland, Ohio.
²¹ Alfred Hospital, Melbourne, Victoria, Australia.
²² Monash University School of Languages Literatures Cultures and Linguistics, Clayton, Victoria, Australia.
²³ Harvard Medical School, Otolaryngology, Boston, Massachusetts.
²⁴ Icahn School of Medicine at Mount Sinai, Otolaryngology, New York, New York.
²⁵ Henry Ford Hospital, Otolaryngology-Head & Neck Surgery, Detroit, Michigan.
²⁶ University of Texas Rio Grande Valley School of Medicine, Department of General Surgery, Edinburg, Texas.
²⁷ St. Mary's Hospital, Imperial College Hospitals NHS Trust, St. Mary's Hospital, London, United Kingdom.
²⁸ OLV Ziekenhuis Aalst, Brussels, Belgium.
²⁹ Hospital das Clinicas-University of Sao Paulo Medical School, Sao Paulo, Brazil.
³⁰ Mount Sinai Hospital, Department of Otolaryngology, Toronto, Ontario, Canada.
³¹ Memorial Sloan-Kettering Cancer Center, Department of Surgery, Head and Neck Service, New York, New York.
³² 865 Indianola Dr, Merritt Island, Florida.
³³ MD Anderson Cancer Center, Head and Neck Surgery, Houston, Texas, U.S.A.
³⁴ Allgemeinchirurgie, Uniklinik Halle, Halle/Saale, Germany.

PMID: 30289983
DOI: 10.1002/lary.27359

Review

International neural monitoring study group guideline 2018 part I: Staging bilateral thyroid surgery with monitoring loss of signal

Rick Schneider et al. Laryngoscope. 2018 Oct.

. 2018 Oct:128 Suppl 3:S1-S17.

doi: 10.1002/lary.27359. Epub 2018 Oct 5.

Authors

Affiliations

¹ Martin Luther University Halle-Wittenberg, Department of General, Visceral, and Vascular Surgery, Halle, Germany.
² Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Harvard Medical School, Boston, Massachusetts.
³ Division of Surgical Oncology, Endocrine Surgery Service, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
⁴ Division for Endocrine Surgery, at the Department of Human Pathology in Adulthood and Childhood "G. Barresi," University Hospital G. Martino, University of Messina, Italy.
⁵ Kaohsiung Medical University Hospital, Kaohsiung Medical University, Otolaryngology-Head and Neck Surgery, Kaohsiung, Taiwan.
⁶ Jagiellonian University, Department of Endocrine Surgery, Third Chair of General Surgery, Krakow, Poland.
⁷ University of Iowa Hospitals and Clinics, Otolaryngology, Iowa City, Iowa.
⁸ University of Chicago, Division of Endocrine Surgery, Department of Surgery, Chicago, Illinois.
⁹ Haukeland Universitetssjukehus, Department of Breast and Endocrine Surgery, Bergen, Norway.
¹⁰ University of Sao Paulo Medical School, Department of Head and Neck Surgery, Sao Paulo, SP, Brazil.
¹¹ Gillies Hospital & Clinics, Epsom, New Zealand.
¹² Cornell University, Clinical Sciences, College of Veterinary Medicine, Ithaca, New York.
¹³ VA Outcomes Group at the Veterans Affairs Medical Center, Norwich, Vermont.
¹⁴ Stadtische Kliniken Neuss Lukaskrankenhaus GmbH, Neuss, Nordrhein-Westfalen, Germany.
¹⁵ Institut Gustave Roussy, Otolaryngology Head & Neck Surgery, Villejuif, France.
¹⁶ Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
¹⁷ State University of New York Upstate Medical University, Otolaryngology, Syracuse, New York.
¹⁸ Northwestern University Feinberg School of Medicine Department of Psychiatry and Behavioral Sciences, Otolaryngology, Chicago, Illinois.
¹⁹ Stanford University School of Medicine, Otolaryngology, Division of Head and Neck Surgery, Stanford, California.
²⁰ Cleveland Clinic, Otolaryngology, Cleveland, Ohio.
²¹ Alfred Hospital, Melbourne, Victoria, Australia.
²² Monash University School of Languages Literatures Cultures and Linguistics, Clayton, Victoria, Australia.
²³ Harvard Medical School, Otolaryngology, Boston, Massachusetts.
²⁴ Icahn School of Medicine at Mount Sinai, Otolaryngology, New York, New York.
²⁵ Henry Ford Hospital, Otolaryngology-Head & Neck Surgery, Detroit, Michigan.
²⁶ University of Texas Rio Grande Valley School of Medicine, Department of General Surgery, Edinburg, Texas.
²⁷ St. Mary's Hospital, Imperial College Hospitals NHS Trust, St. Mary's Hospital, London, United Kingdom.
²⁸ OLV Ziekenhuis Aalst, Brussels, Belgium.
²⁹ Hospital das Clinicas-University of Sao Paulo Medical School, Sao Paulo, Brazil.
³⁰ Mount Sinai Hospital, Department of Otolaryngology, Toronto, Ontario, Canada.
³¹ Memorial Sloan-Kettering Cancer Center, Department of Surgery, Head and Neck Service, New York, New York.
³² 865 Indianola Dr, Merritt Island, Florida.
³³ MD Anderson Cancer Center, Head and Neck Surgery, Houston, Texas, U.S.A.
³⁴ Allgemeinchirurgie, Uniklinik Halle, Halle/Saale, Germany.

PMID: 30289983
DOI: 10.1002/lary.27359

Abstract

This publication offers modern, state-of-the-art International Neural Monitoring Study Group (INMSG) guidelines based on a detailed review of the recent monitoring literature. The guidelines outline evidence-based definitions of adverse electrophysiologic events, especially loss of signal, and their incorporation in surgical strategy. These recommendations are designed to reduce technique variations, enhance the quality of neural monitoring, and assist surgeons in the clinical decision-making process involved in surgical management of recurrent laryngeal nerve. The guidelines are published in conjunction with the INMSG Guidelines Part II, Optimal Recurrent Laryngeal Nerve Management for Invasive Thyroid Cancer-Incorporation of Surgical, Laryngeal, and Neural Electrophysiologic Data. Laryngoscope, 128:S1-S17, 2018.

Keywords: IONM; Thyroid surgery; bilateral thyroid surgery; intraoperative neural monitoring; laryngeal exam; loss of signal; staged surgery; vocal cord paralysis.

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International neural monitoring study group guideline 2018 part I: Staging bilateral thyroid surgery with monitoring loss of signal

Affiliations

International neural monitoring study group guideline 2018 part I: Staging bilateral thyroid surgery with monitoring loss of signal

Authors

Affiliations

Abstract

Publication types

MeSH terms