title: Safety of neural monitoring in thyroid surgery.
abstract: During thyroid surgery, the functional integrity of the recurrent laryngeal nerve (RLN) is not only threatened by direct nerve injury resulting from accidental transection, clipping or ligation. In fact, indirect trauma, e.g. traction and compression occurring repeatedly throughout gland dissection, contribute to long-term nerve impairment. In order to avoid RLN lesions and preserve nerve function the surgeon must adhere to and comply with a strict standardized intraoperative neuromonitoring (IONM) technique to preserve results, quality and safety. IONM should be a team work between the surgeon and the anesthesiologist.
authors.affiliation: Department of Surgical Sciences, University of Insubria, Varese-Como, Italy.
authors.forename: Gianlorenzo
authors.initials: G
authors.lastname: Dionigi
authors.affiliation: Department of Otolaryngology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan.
authors.forename: Feng-Yu
authors.initials: FY
authors.lastname: Chiang
authors.affiliation: Department of General, Visceral, and Vascular Surgery, Martin Luther University Halle-Wittenberg, Halle, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Dralle
authors.affiliation: Department of Surgical Sciences, University of Insubria, Varese-Como, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Boni
authors.affiliation: Department of Surgical Sciences, University of Insubria, Varese-Como, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Rausei
authors.affiliation: Department of Surgical Sciences, University of Insubria, Varese-Como, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Rovera
authors.affiliation: Department of Clinical Medicine, Endocrinology - University of Insubria, Varese-Como, Italy.
authors.forename: Eliana
authors.initials: E
authors.lastname: Piantanida
authors.affiliation: Department of Surgical Sciences, University of Insubria, Varese-Como, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Mangano
authors.affiliation: Department of Endocrine Surgery, 3rd Chair of General Surgery, Jagiellonian University, Krakow, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Barczyński
authors.affiliation: Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA.
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Randolph
authors.affiliation: Department of Surgical Sciences, University of Insubria, Varese-Como, Italy.
authors.forename: Renzo
authors.initials: R
authors.lastname: Dionigi
authors.affiliation: Department of General and Visceral Surgery, Robert-Bosch-Hospital, Stuttgart, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Ulmer
mesh_terms: D006801:Humans; D007431:Intraoperative Complications; D064795:Intraoperative Neurophysiological Monitoring / Q000379:methods; D009420:Nervous System / Q000033:anatomy & histology; D013961:Thyroid Gland / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects* / Q000379:methods*
keywords: Continuous IONM; Intraoperative neuromonitoring; Safety; Thyroid surgery