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

Objective: To evaluate the clinical value of intraoperative nerve monitoring (IONM) by comparing the procedure times for thyroidectomies performed with and without IONM. Methods: A prospective, randomized, controlled study was conducted on 32 patients (representing 41 nerves at risk) undergoing thyr...

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Main Authors: Prachya Maneeprasopchoke, Cheerasook Chongkolwatana, Warut Pongsapich, Ayaka J. Iwata, Dipti Kamani, Gregory W. Randolph
Other Authors: Siriraj Hospital
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Published: 2022
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Online Access:https://repository.li.mahidol.ac.th/handle/123456789/78305
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spelling th-mahidol.783052022-08-04T16:27:24Z Intraoperative nerve monitoring in thyroid surgery: Analysis of recurrent laryngeal nerve identification and operative time Prachya Maneeprasopchoke Cheerasook Chongkolwatana Warut Pongsapich Ayaka J. Iwata Dipti Kamani Gregory W. Randolph Siriraj Hospital Harvard Medical School Medicine Objective: To evaluate the clinical value of intraoperative nerve monitoring (IONM) by comparing the procedure times for thyroidectomies performed with and without IONM. Methods: A prospective, randomized, controlled study was conducted on 32 patients (representing 41 nerves at risk) undergoing thyroidectomies carried out by two experienced head and neck surgeons (CC & WP). Sixteen thyroidectomies were performed without IONM (the “non-IONM group”), while 16 thyroidectomies were performed with IONM (the “IONM group”). The measured datapoints were setup time, time to visual identification of the recurrent laryngeal nerve (RLN), time to confirm the RLN electrophysiologically, dissection time, and total operative time. Results: With both surgeons, the IONM group had shorter visual times to RLN identification than the non-IONM group (CC: 3.7 minutes vs 5.3 minutes; WP: 3.4 minutes vs 9.7 minutes). Additionally, the electrophysiological identification time for the IONM group was shorter than the visual identification time for the non-IONM group. The setup times, dissection times, and total operative times of the 2 groups did not significantly differ (P >.05). No RLN injuries were observed. Conclusions: IONM reduces the time needed for RLN identification in thyroidectomies. Functional RLN confirmation can reassure surgeons of the operative results. Moreover, use of IONM does not significantly impact setup and total operative times. Level of evidence: 2. 2022-08-04T09:27:24Z 2022-08-04T09:27:24Z 2021-04-01 Article Laryngoscope Investigative Otolaryngology. Vol.6, No.2 (2021), 354-361 10.1002/lio2.543 23788038 2-s2.0-85104344985 https://repository.li.mahidol.ac.th/handle/123456789/78305 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85104344985&origin=inward
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Medicine
spellingShingle Medicine
Prachya Maneeprasopchoke
Cheerasook Chongkolwatana
Warut Pongsapich
Ayaka J. Iwata
Dipti Kamani
Gregory W. Randolph
Intraoperative nerve monitoring in thyroid surgery: Analysis of recurrent laryngeal nerve identification and operative time
description Objective: To evaluate the clinical value of intraoperative nerve monitoring (IONM) by comparing the procedure times for thyroidectomies performed with and without IONM. Methods: A prospective, randomized, controlled study was conducted on 32 patients (representing 41 nerves at risk) undergoing thyroidectomies carried out by two experienced head and neck surgeons (CC & WP). Sixteen thyroidectomies were performed without IONM (the “non-IONM group”), while 16 thyroidectomies were performed with IONM (the “IONM group”). The measured datapoints were setup time, time to visual identification of the recurrent laryngeal nerve (RLN), time to confirm the RLN electrophysiologically, dissection time, and total operative time. Results: With both surgeons, the IONM group had shorter visual times to RLN identification than the non-IONM group (CC: 3.7 minutes vs 5.3 minutes; WP: 3.4 minutes vs 9.7 minutes). Additionally, the electrophysiological identification time for the IONM group was shorter than the visual identification time for the non-IONM group. The setup times, dissection times, and total operative times of the 2 groups did not significantly differ (P >.05). No RLN injuries were observed. Conclusions: IONM reduces the time needed for RLN identification in thyroidectomies. Functional RLN confirmation can reassure surgeons of the operative results. Moreover, use of IONM does not significantly impact setup and total operative times. Level of evidence: 2.
author2 Siriraj Hospital
author_facet Siriraj Hospital
Prachya Maneeprasopchoke
Cheerasook Chongkolwatana
Warut Pongsapich
Ayaka J. Iwata
Dipti Kamani
Gregory W. Randolph
format Article
author Prachya Maneeprasopchoke
Cheerasook Chongkolwatana
Warut Pongsapich
Ayaka J. Iwata
Dipti Kamani
Gregory W. Randolph
author_sort Prachya Maneeprasopchoke
title Intraoperative nerve monitoring in thyroid surgery: Analysis of recurrent laryngeal nerve identification and operative time
title_short Intraoperative nerve monitoring in thyroid surgery: Analysis of recurrent laryngeal nerve identification and operative time
title_full Intraoperative nerve monitoring in thyroid surgery: Analysis of recurrent laryngeal nerve identification and operative time
title_fullStr Intraoperative nerve monitoring in thyroid surgery: Analysis of recurrent laryngeal nerve identification and operative time
title_full_unstemmed Intraoperative nerve monitoring in thyroid surgery: Analysis of recurrent laryngeal nerve identification and operative time
title_sort intraoperative nerve monitoring in thyroid surgery: analysis of recurrent laryngeal nerve identification and operative time
publishDate 2022
url https://repository.li.mahidol.ac.th/handle/123456789/78305
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