Our findings showed that the use of IONM decreased significantly both temporary and permanent RLN injuries. The technology of IONM is safe and reliable, and this technique is an important adjunct in nerve dissection and functional neural integrity. The routine use of IONM reduced pitfalls and provided guidance for our surgeons in difficult cases, reoperations, and high-risk patients.

No abstract

Our results indicate that a high rate of PTMC presented 1 or more risk factors including multifocality, bilaterality, capsule invasion, and lymph node metastasis. Therefore, we suggest total thyroidectomy followed by adequate exploration of the central neck compartment for possible nodal involvement and resection as a safe therapeutic approach.

Patients presenting multifocal, bilateral PTMC with a maximum diameter > 5 mm and thyroid capsule invasion may have an increased risk of lymph node metastasis. These factors should be considered in the follow-up for these patients.

The incidence of PTC in GD-positive patients is higher than that in GD-negative patients. Aggressive variants of PTC, such as the TCV, were more frequent in nodular micro-PTC. These findings suggest that prompt and meticulous evaluation of nodules in any patient with GD associated with nodular alterations must be considered.