[Neurostimulation of the recurrent laryngeal nerve--a routine method in thyroid gland surgery?].
BACKGROUND
Thyroid operations belong to the most frequent procedures in Germany (100,000/year). An important quality parameter is the incidence of postoperative recurrent nerve paralysis. Intraoperative identification by visualization of the nerve with a paralysis rate of 1% is the present gold standard in dedicated centers.


OBJECTIVE
Can this results be further improved by use of an intraoperative neuromonitoring system (NM).


RESULTS
The use of NM is helpful in difficult situations (recurrent goiter, advanced carcinoma, anatomic variants), but a quality improvement is not yet proven.


CONCLUSIONS
NM can not replace the current nerve identification by meticulous preparation of anatomic structures. It should be used at the discretion of the operative surgeon.
Schulte
K M
KM
Klinik für Allgemein- und Unfallchirurgie, Universitätsklinikum Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf.
Cupisti
K
K
Röher
H D
HD
D004568:Electrodiagnosis; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000503:physiopathology; D016343:Monitoring, Intraoperative; D011183:Postoperative Complications / Q000503:physiopathology / Q000517:prevention & control; D012009:Recurrent Laryngeal Nerve / Q000503:physiopathology; D061226:Recurrent Laryngeal Nerve Injuries; D012307:Risk Factors; D013965:Thyroidectomy; D014826:Vocal Cord Paralysis / Q000503:physiopathology / Q000517:prevention & control