First experiences in intraoperative neurostimulation of the recurrent laryngeal nerve during thyroid surgery of children and adolescents.
BACKGROUND
Intraoperative neurostimulation of the recurrent laryngeal nerve may reduce nerve palsy during thyroid surgery and is well established in adults. No data regarding the value of neuromonitoring during thyroid surgery in children have been available.


METHODS
In a retrospective study, the authors analyzed all children who underwent surgery in our department since 1995. Neurostimulation was performed as electromyography of the vocal muscle using an electrical stimulation electrode for identification of the recurrent nerve.


RESULTS
The authors performed thyroid resections in 97 children (mean, 11.1 years), 75 because of thyroid carcinoma. The recurrent nerve was identified in each patient. The neuromonitoring was used in 53 patients. Postoperatively, one temporary nerve palsy was identified in this group (1.89%). In the group of 44 nonstimulated patients, 2 temporary (4.55%) and one permanent nerve dysfunctions (2.27%) occurred. In all stimulated patients, the results of intraoperative neurostimulation were identical with the postoperative function of the vocal cords.


CONCLUSIONS
The intraoperative neurostimulation of the recurrent laryngeal nerve is a safe and reliable procedure in children and adolescents. It may reduce nerve damage during thyroid surgery. The neuromonitoring of the recurrent nerve is of high prediction for the postoperative function of the vocal cords.
Brauckhoff
Michael
M
Department of General, Visceral, and Vascular Surgery, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany.
Gimm
Oliver
O
Thanh
Phuong Nguyen
PN
Brauckhoff
Katrin
K
Ukkat
Jörg
J
Thomusch
Oliver
O
Dralle
Henning
H
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004558:Electric Stimulation / Q000379:methods*; D004576:Electromyography / Q000379:methods; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D012009:Recurrent Laryngeal Nerve / Q000502:physiology*; D061226:Recurrent Laryngeal Nerve Injuries; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects; D014826:Vocal Cord Paralysis / Q000453:epidemiology / Q000517:prevention & control