title: Electrophysiological neuromonitoring of the laryngeal nerves in thyroid and parathyroid surgery: A review.
abstract: Recurrent laryngeal nerve (RLN) injury is one of the most common complications of thyroid surgery. Injury to the external branch of the superior laryngeal nerve is less obvious and affects the voice variably; however, it can be of great significance to professional voice users. Recent literature has led to an increase in the use of neuromonitoring as an adjunct to visual nerve identification during thyroid surgery. In our review of the literature, we discuss the application, efficacy and safety of neuromonitoring in thyroid surgery. Although intraoperative neuromonitoring (IONM) contributes to the prevention of laryngeal nerves injury, there was no significant difference in the incidence of RLN injury in thyroid surgery when IONM was used compared with visual identification alone. IONM use is recommended in high risk patients; however, there are no clear identification criteria for what constitutes "high risk". There is no clear evidence that IONM decreases the risk of laryngeal nerve injury in thyroid surgery. However, continuous IONM provides a promising tool that can prevent imminent nerve traction injury by detecting decreased amplitude combined with increased latency.
authors.affiliation: Ahmed Deniwar, Parisha Bhatia, Emad Kandil, Division of Endocrine and Oncologic Surgery, Department of Surgery, Tulane University School of Medicine, New Orleans, LA 70112, United States.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Deniwar
authors.affiliation: Ahmed Deniwar, Parisha Bhatia, Emad Kandil, Division of Endocrine and Oncologic Surgery, Department of Surgery, Tulane University School of Medicine, New Orleans, LA 70112, United States.
authors.forename: Parisha
authors.initials: P
authors.lastname: Bhatia
authors.affiliation: Ahmed Deniwar, Parisha Bhatia, Emad Kandil, Division of Endocrine and Oncologic Surgery, Department of Surgery, Tulane University School of Medicine, New Orleans, LA 70112, United States.
authors.forename: Emad
authors.initials: E
authors.lastname: Kandil
keywords: Neuromonitoring; Recurrent laryngeal nerve; Superior laryngeal nerve; Thyroid surgery