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Review
. 2024 Mar 18;12(3):675.
doi: 10.3390/biomedicines12030675.

Current Knowledge on the Use of Neuromonitoring in Thyroid Surgery

Beata Wojtczak  1 , Karolina Sutkowska-Stępień  1 , Mateusz Głód  2 , Krzysztof Kaliszewski  1 , Krzysztof Sutkowski  1 , Marcin Barczyński  3
Affiliations
Review

Current Knowledge on the Use of Neuromonitoring in Thyroid Surgery

Beata Wojtczak et al. Biomedicines. .

Abstract

Thyroid surgery rates have tripled over the past three decades, making it one of the most frequently performed procedures within general surgery. Thyroid surgery is associated with the possibility of serious postoperative complications which have a significant impact on the patient's quality of life. Recurrent laryngeal nerve (RLN) palsy and external branch of the superior laryngeal nerve (EBSLN) palsy are, next to hypoparathyroidism and postoperative bleeding, some of the most common complications. The introduction of neuromonitoring into thyroid surgery, which enabled both the confirmation of anatomical integrity and the assessment of laryngeal nerve function, was a milestone that began a new era in thyroid surgery. The International Neural Monitoring Study Group has produced a standardization of the technique of RLN and EBSLN monitoring during thyroid and parathyroid surgery, which in turn increased the prevalence of neural monitoring during thyroidectomy. The current status of IONM and the benefits of its use have been presented in this publication.

Keywords: intraoperative nerve monitoring; recurrent laryngeal nerves; thyroid surgery; vocal fold paresis.

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Conflict of interest statement

Author Mateusz Głód was employed by the company Infermedica Sp. z o.o. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Anatomy of the recurrent laryngeal nerve and the superior laryngeal nerve.
Figure 2
Figure 2
Non-recurrent laryngeal nerve.
Figure 3
Figure 3
External branch of the superior laryngeal nerve. (STA—superior thyroid artery, EBSLN—external branch of the superior laryngeal nerve, CTM—cricothyroid muscle).
Figure 4
Figure 4
IONM—intraoperative nerve monitoring.
Figure 5
Figure 5
Amplitude and latency pattern during IONM. (I)—baseline latency and amplitude, (II)—amplitude—decreased, latency—increased.
Figure 6
Figure 6
NIM NerveTrendTM mode: sCE followed by LOS and recovery of EMG signal can be recognized by the system to allow for intraoperative tailoring of surgical approach [courtesy of Marcin Barczyński].
See this image and copyright information in PMC

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