title: Laryngeal neuromonitoring and neurostimulation versus neurostimulation alone in thyroid surgery: a randomized clinical trial.
abstract: BACKGROUND
  The aim of this study was to assess a prospective, randomized clinical trial (RCT) comparing neurostimulation with laryngeal palpation (NSLP) of recurrent laringeal nerve (RLN) alone with NSLP associated with laryngeal neuromonitoring (LNM) to evaluate the ability of LNM in reducing the rates of RLN palsy.
  
  
  METHODS
  In all, 250 consecutive patients scheduled to have thyroidectomy were randomized to NSLP alone (NSLP group) or NSLP with LNM (LNM group). The primary endpoint was to assess the rate of RLN palsy.
  
  
  RESULTS
  The incidence of palsy was 2.7% in the LMN group and 2.6% in the NSLP group. No significant statistical difference between the groups was observed either for permanent or for transient paralysis (respectively, Fisher's Exact test: p = 1.0 and p = 1.0).
  
  
  CONCLUSIONS
  This RCT shows that the use of LNM during thyroidectomy does not reduce the rates of recurrent laryngeal injuries compared with NSLP alone.
authors.affiliation: Department of Otolaryngology, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. ocavicchi@gmail.com
authors.forename: Ottavio
authors.initials: O
authors.lastname: Cavicchi
authors.forename: Umberto
authors.initials: U
authors.lastname: Caliceti
authors.forename: Ignacio Javier
authors.initials: IJ
authors.lastname: Fernandez
authors.forename: Alberto Rinaldi
authors.initials: AR
authors.lastname: Ceroni
authors.forename: Alessandra
authors.initials: A
authors.lastname: Marcantoni
authors.forename: Silvia
authors.initials: S
authors.lastname: Sciascia
authors.forename: Sandra
authors.initials: S
authors.lastname: Sottili
authors.forename: Ottavio
authors.initials: O
authors.lastname: Piccin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004558:Electric Stimulation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D008991:Monitoring, Physiologic; D011446:Prospective Studies; D012009:Recurrent Laryngeal Nerve / Q000502:physiology; D061226:Recurrent Laryngeal Nerve Injuries / Q000517:prevention & control; D013965:Thyroidectomy / Q000379:methods*; D014826:Vocal Cord Paralysis / Q000517:prevention & control*; D055815:Young Adult