title: Intraoperative nerve monitoring in thyroid surgery.
abstract: BACKGROUND
  Nerve injury is one of the specific complications of thyroid surgery despite many advances in surgical technique. The recurrent laryngeal nerve (RLN) and the external branch of superior laryngeal nerve are the nerves at risk during thyroid surgery (1). Morbidity related to recurrent laryngeal nerve injury varies from changes in voice quality to severe dyspnea requiring tracheal intubation or tracheostomy. To minimize the risk of nerve injury, intraoperative nerve monitoring (IONM) being suggested as a tool for helping visual control for RLN has gained significant interest in recent years (1,2). We aimed to determine the effectiveness of nerve monitoring during thyroid surgery and to provide a clinical experience.
  
  
  METHODS
  This study was performed from June 2010 to June 2012. We prospectively evaluated 94 patients who had thyroid surgery with or without nerve monitoring. Of those patients 48 were in monitored group (M) and 46 were in unmonitored group (UM).
  
  
  RESULTS
  The mean age was 48 (27-76) in M group and 52 (73-17) in UM. There was only one patient had transient hoarseness in M group and also one patient had transient hoarseness in UM group. One each in both groups had persistent hoarseness. No patients experienced airway problem. Operation time was significantly shorter in M group (p<0.001).
  
  
  CONCLUSIONS
  Use of a nerve monitoring system does not substitute for careful dissection and visual identification of nerves, but monitoring can assist the surgeon in identifying the RLN anatomic variability and may decrease the operation time during thyroid surgery.
authors.forename: Ayfer Kamali
authors.initials: AK
authors.lastname: Polat
authors.forename: Gokhan
authors.initials: G
authors.lastname: Lap
authors.forename: Selcuk
authors.initials: S
authors.lastname: Ozbalci
authors.forename: Kagan
authors.initials: K
authors.lastname: Karabulut
authors.forename: Bulent
authors.initials: B
authors.lastname: Gungor
authors.forename: Cafer
authors.initials: C
authors.lastname: Polat
authors.forename: Kenan
authors.initials: K
authors.lastname: Erzurumlu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D061226:Recurrent Laryngeal Nerve Injuries / Q000209:etiology / Q000517:prevention & control*; D013961:Thyroid Gland / Q000601:surgery*; D055815:Young Adult