Negative and positive predictive values of nerve monitoring in thyroidectomy

Abstract

In the present series, nerve monitoring had a very high PPV but a low NPV for the detection of recurrent nerve injury.

Acute prediction of laryngeal outcome during thyroid surgery by electromyographic laryngeal monitoring

“…Our statistical results are consistent with several works proving that our cohort is representative despite its low size. All studies found a high NPV (>99%) and a low PPV (11% to 62%) . This confirms that the RLN monitoring is very powerful to predict a good postoperative laryngeal mobility.…”

Complications after total thyroidectomy

“…In a prospective series of 447 patients, NM had a 40% positive predictive value and a 100% negative predictive value for nerve injury with a sensitivity of 63% and a specificity of 97% [44]. In a comparison of RLN identification by standard dissection versus NM in a series of 1000 patients undergoing total thyroidectomy, Barczynski showed that NM diminished the incidence of transient RLN paresis (2.9% for high-risk patients and 0.9% for low-risk patients) [45].…”

Prospective study of vocal fold function after loss of the neuromonitoring signal in thyroid surgery: The International Neural Monitoring Study Group's POLT study

“…Intraoperative neuromonitoring, marrying intraoperative identification of the recurrent laryngeal nerve's (RLN) anatomical course with evaluation of RLN function, has matured into a valuable adjunct to thyroid surgery . In a recent observational study, operation with continuous intraoperative neuromonitoring resulted in fewer permanent vocal fold palsies after thyroid surgery in patients with benign disease than operations with intermittent intraoperative neuromonitoring .…”