title: Intermittent Intraoperative Neural Monitoring Technology in Minimally Invasive Video-Assisted Thyroidectomy: A Preliminary Study.
abstract: OBJECTIVE
  Intraoperative neural monitoring (IONM) technology was applied in minimally invasive video-assisted thyroidectomy (MIVAT) to explore its safety and effectiveness.
  
  
  METHODS
  Data were collected retrospectively from October 2009 to August 2011. Inclusion criteria included the following: (1) benign thyroid nodule with maximum diameter less than 4.0 cm by preoperative ultrasound evaluation; (2) no previous thyroid surgeries; (3) no cervical radiation history; (4) normal function of recurrent laryngeal nerve (RLN) examined by preoperative laryngoscopy; (5) patients who did not accept to take a "wait and see" follow-up strategy. Enrolled patients were randomly allocated into NIM group and control group.
  
  
  RESULTS
  46 patients were enrolled in NIM group, and 51 patients were enrolled in control group. All surgeries in NIM group were performed successfully, and majority of tracheal intubations were placed with one attempt. 47 RLNs in NIM group and 60 RLNs in control group were exposed. The time of RLN locating was 6.06 ± 1.48 min in NIM group and 6.92 ± 1.34 min in control group (p = .02). The time of RLN tracing and exposing was 28.96 ± 4.75 min in NIM group and 32.17 ± 5.56 min in control group (p = .02). 1 case of temporary RLN paralysis was observed in both groups, and no permanent RLN paralysis was reported.
  
  
  CONCLUSIONS
  The application of intermittent IONM in MIVAT is feasible. Intermittent IONM can help reduce the time of RLN locating and the time of RLN tracing and exposing.
authors.affiliation: a Department of Thyroid and Neck , The Affiliated Cancer Hospital of Zhengzhou University , Henan Cancer Hospital, Zhengzhou, China.
authors.forename: Hu
authors.initials: H
authors.lastname: Hei
authors.affiliation: a Department of Thyroid and Neck , The Affiliated Cancer Hospital of Zhengzhou University , Henan Cancer Hospital, Zhengzhou, China.
authors.forename: Yifei
authors.initials: Y
authors.lastname: Zhai
authors.affiliation: a Department of Thyroid and Neck , The Affiliated Cancer Hospital of Zhengzhou University , Henan Cancer Hospital, Zhengzhou, China.
authors.forename: Jianwu
authors.initials: J
authors.lastname: Qin
authors.affiliation: b Department of Hematology , The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital , Zhengzhou , China.
authors.forename: Yongping
authors.initials: Y
authors.lastname: Song
mesh_terms: D000328:Adult; D000368:Aged; D004576:Electromyography; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D010243:Paralysis / Q000209:etiology; D011897:Random Allocation; D061226:Recurrent Laryngeal Nerve Injuries / Q000175:diagnosis / Q000517:prevention & control*; D012189:Retrospective Studies; D016606:Thyroid Nodule / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods*; D014463:Ultrasonography; D020535:Video-Assisted Surgery / Q000379:methods*; D055815:Young Adult
keywords: intraoperative neural monitoring; recurrent laryngeal nerve; thyroidectomy; video-assisted surgery