The utilization of intra-operative recurrent laryngeal nerve monitoring in predicting vocal fold mobility after thyroid and parathyroid surgery

Abstract

The role of intraoperative nerve monitoring in thyroid and parathyroid surgery has evolved over the past 15 years. Despite advances in technology there remains controversy regarding the role of nerve monitoring. The purpose of this paper was to review the relevant literature on the topic of intraoperative nerve monitoring with a particular emphasis on the efficacy of nerve monitoring to predict postoperative vocal fold mobility. In addition the paper will assess the role of nerve monitoring as an adjunct to clinical judgment regarding staging bilateral thyroid surgery when the first nerve fails to respond to intraoperative stimulation.

Intraoperative nerve monitoring in thyroid surgery: Analysis of recurrent laryngeal nerve identification and operative time

“…Even though the operative time for the IONM group was longer (due to extra time being needed by the anesthesiologist to position the ETT electrode), less than 5 to 10 minutes was required for setting up and troubleshooting. Miller et al 18 found that the setup time was minimized when the RLN was routinely monitored; moreover, those researchers found that, with experience, the setting up of the system could be as quick as with the conventional technique. This is likely why IONM yielded no significant effects on the total operative times in the previous studies.…”