Evaluation of recurrent laryngeal nerve monitoring in thyroid surgery.
OBJECTIVE
Thyroidectomy creates a potential risk for all parathyroid glands and nerves. Nerve identification has decreased the rates of nerve injury during thyroidectomy. Intraoperative nerve monitoring (IONM) has been used as an adjunct to the visual identification of the nerve. The aim of this clinical trial is to evaluate the effect of the identification time of RLN during thyroidectomy using IONM.


METHODS
Two hundred and thirty seven patients and 409 nerves at risk were enrolled in this prospective study. The nerves in Group 1 (n=210) were identified with IONM, whereas the nerves in Group 2 (n=199) were identified without IONM.


RESULTS
The identification time of RLN and the operating time in patients of Group 1 were significantly lower than patients of Group 2. There was not any significant difference between postoperative complications of the groups. According to logistic regression analysis, the use of IONM was found to be the only determinant of the decrease of identification time of RLN.


CONCLUSIONS
Although the operating time was lower with IONM than with visualization alone, the shortened surgical time may not seem to have great clinical relevance. However, the shorter the nerve is identified the lower is the surgeon's level of stress. We think that it is important to use IONM to decrease the identification time of RLN in the course of thyroidectomy.
Sarı
Serkan
S
Istanbul University, Istanbul Medical Faculty, Department of General Surgery, 34093 Capa, Istanbul, Turkey.
Erbil
Yeşim
Y
Sümer
Aziz
A
Agcaoglu
Orhan
O
Bayraktar
Adem
A
Issever
Halim
H
Ozarmagan
Selcuk
S
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D012009:Recurrent Laryngeal Nerve / Q000502:physiology*; D061226:Recurrent Laryngeal Nerve Injuries; D012307:Risk Factors; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods*; D014826:Vocal Cord Paralysis / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*