title: The impact of recurrent laryngeal neuromonitoring on multi-dimensional voice outcomes following thyroid surgery.
abstract: BACKGROUND
  Voice changes after thyroidectomy are common but not always related to recurrent laryngeal nerve (RLN) injury. We evaluated if RLN neuromonitoring correlated with non-RLN injury-related changes in voice after thyroidectomy.
  
  
  METHODS
  Prospective multi-dimensional voice assessment was conducted on patients undergoing thyroidectomy before, 1-4 weeks, and 6 months postoperatively. Voice outcome (VO) was determined as normal (NormVO) or negative (NegVO) based upon combinations of patient-reported symptoms, videolaryngoscopy, a composite of acoustic measurements, and clinician-perceived voice quality. Groups with and without neuromonitoring were compared for early and durable differences in VO.
  
  
  RESULTS
  Ninety-one patients underwent thyroidectomy; 39 with RLN neuromonitoring and 52 without. The two study groups were similar with regard to baseline characteristics including voice assessment. There was no difference in NegVO between neuromonitored and non-monitored patients at 1-4 weeks (n = 89; 32% vs. 27%; P = 0.81) and 6 months (n = 71, 14% vs. 7%; P = 0.42) after thyroidectomy. Neuromonitoring was associated with a 48-min increase in median operative time, but this finding was not statistically significant in a multivariate model.
  
  
  CONCLUSIONS
  In this study, recurrent laryngeal neuromonitoring did not appear to influence non-RLN injury related VO as measured by a comprehensive multidimensional voice assessment.
authors: Naval Medical Research Center, Silver Spring, Maryland, USA.
authors: Kristin
authors: K
authors: Stevens
authors: Alexander
authors: A
authors: Stojadinovic
authors: Leah B
authors: LB
authors: Helou
authors: Nancy P
authors: NP
authors: Solomon
authors: Robin S
authors: RS
authors: Howard
authors: Craig D
authors: CD
authors: Shriver
authors: Chester C
authors: CC
authors: Buckenmaier
authors: Leonard R
authors: LR
authors: Henry
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012009:Recurrent Laryngeal Nerve / Q000503:physiopathology*; D061226:Recurrent Laryngeal Nerve Injuries / Q000175:diagnosis* / Q000209:etiology; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects*; D014827:Vocal Cords / Q000503:physiopathology*; D014832:Voice Disorders / Q000175:diagnosis* / Q000209:etiology; D014833:Voice Quality