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Value of intra-operative neuromonitoring of the recurrent laryngeal nerve in total thyroidectomy for benign goitre

Published online by Cambridge University Press:  15 June 2015

C Page ,
P Cuvelier ,
A Biet  and
V Strunski
C Page*
Affiliation:
ENT and Head & Neck Department, Amiens University Hospital, France
P Cuvelier
Affiliation:
ENT and Head & Neck Department, Amiens University Hospital, France
A Biet
Affiliation:
ENT and Head & Neck Department, Amiens University Hospital, France
V Strunski
Affiliation:
ENT and Head & Neck Department, Amiens University Hospital, France
*
Address for correspondence: Dr C Page, Service d'ORL et de Chirurgie de la Face et du Cou, Centre Hospitalier Nord, Place Victor Pauchet, 80054 Amiens CEDEX, France Fax: 0322668623 E-mail: [email protected]
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Abstract

Objective:

This study aimed to evaluate the impact of intra-operative neuromonitoring of the recurrent laryngeal nerve during total thyroidectomy for benign goitre.

Methods:

A single-centre retrospective study using historical controls was conducted for a 10-year period, comprising a series of 767 patients treated by total thyroidectomy for benign goitre. Of these, 306 had intra-operative neuromonitoring of the recurrent laryngeal nerve and 461 did not. Post-operative laryngeal mobility was assessed in all patients by direct laryngoscopy before hospital discharge and at post-operative follow-up visits.

Results:

In all, 6 out of 461 patients (1.30 per cent) in the control group and 6 out of 306 patients (1.96 per cent) in the intra-operative neuromonitoring group developed permanent recurrent laryngeal nerve palsy. No statistically significant difference was observed between the two patient groups.

Conclusion:

Intra-operative neuromonitoring does not appear to affect the post-operative recurrent laryngeal nerve palsy rate or to reliably predict post-operative recurrent laryngeal nerve palsy. However, it can accurately predict good nerve function after thyroidectomy.

Keywords

Thyroid GlandComplicationsRecurrent Laryngeal Nerve PalsyLaryngeal NerveInferiorIntraoperative Neurophysiological Monitoring
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 6 , June 2015 , pp. 553 - 557
Copyright
Copyright © JLO (1984) Limited 2015 

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References

1Dralle, H, Lorenz, K, Manchens, A. Verdicts on malpractice claims after thyroid surgery: emerging trend and future directions. Head Neck 2012;34:1591–6CrossRefGoogle ScholarPubMed
2Barczyński, M, Konturek, A, Cichoń, S. Randomized clinical trial of visualization versus neuromonitoring of recurrent laryngeal nerves during thyroidectomy. Br J Surg 2009;96:240–6CrossRefGoogle ScholarPubMed
3Dralle, H, Sekulla, C, Haerting, J, Timmermann, W, Neumann, HJ, Kruse, E et al. Risk factors of paralysis and functional outcome after recurrent laryngeal nerve monitoring in thyroid surgery. Surgery 2004;136:1310–22CrossRefGoogle ScholarPubMed
4Chan, WF, Lang, BH, Lo, CY. The role of intraoperative neuromonitoring of recurrent laryngeal nerve during thyroidectomy: a comparative study on 1000 nerves at risk. Surgery 2006;140:866–72CrossRefGoogle ScholarPubMed
5Shindo, M, Chheda, NN. Incidence of vocal cord paralysis with and without recurrent laryngeal nerve monitoring during thyroidectomy. Arch Otolaryngol Head Neck Surg 2007;133:481–5CrossRefGoogle ScholarPubMed
6Robertson, ML, Steward, DL, Gluckman, JL, Welge, J. Continuous laryngeal nerve integrity monitoring during thyroidectomy: does it reduce risk of injury? Otolaryngol Head Neck Surg 2004;131:596–600CrossRefGoogle ScholarPubMed
7Thomusch, O, Sekulla, C, Walls, G, Machens, A, Dralle, H. Intraoperative neuromonitoring of surgery for benign goiter. Am J Surg 2002;183:673–8CrossRefGoogle ScholarPubMed
8Dralle, H, Sekulla, C, Lorenz, K, Brauckhoff, M, Machens, A. German IONM Study Group. Intraoperative monitoring of the recurrent laryngeal nerve in thyroid surgery. World J Surg 2008;32:1358–66CrossRefGoogle Scholar
9Hermann, M, Alk, G, Roka, R, Glaser, K, Freissmuth, M. Laryngeal recurrent nerve injury in surgery for benign thyroid disease: effect of the nerve dissection and impact of individual surgeon in more than 27,000 nerves at risk. Ann Surg 2002;235:261–8CrossRefGoogle Scholar
10Sitges-Serra, A, Fontané, J, Dueñas, JP, Duque, CS, Lorente, L, Trillo, L et al. Prospective study on loss of signal on the first side during neuromonitoring of the recurrent laryngeal nerve in total thyroidectomy. Br J Surg 2013;100:662–6; discussion 666–7CrossRefGoogle ScholarPubMed
11Phelan, E, Potenza, A, Slough, C, Zurakowski, D, Kamani, D, Randolph, G. Recurrent laryngeal nerve monitoring during thyroid surgery: normative vagal and recurrent laryngeal nerve electrophysiological data. Otolaryngol Head Neck Surg 2012;147:640–6CrossRefGoogle ScholarPubMed
12Melin, M, Schwarz, K, Lammers, BJ, Goretzki, PE. IONM-guided goiter surgery leading to two-stage thyroidectomy – indication and results. Langenbecks Arch Surg 2013;398:411–18CrossRefGoogle ScholarPubMed
13Sadowski, SM, Soardo, P, Leuchter, I, Robert, JH, Triponez, F. Systematic use of recurrent laryngeal nerve neuromonitoring changes the operative strategy in planned bilateral thyroidectomy. Thyroid 2013;23:329–33CrossRefGoogle ScholarPubMed
14Laccourreye, O, Chabolle, F. Laryngeal neuromonitoring in total thyroidectomy for benign goiter: Germany leads the way! Eur Ann Otorhinolaryngol Head Neck Dis 2013;130:301–2CrossRefGoogle ScholarPubMed
15Page, C, Peltier, J, Charlet, L, Laude, M, Strunski, V. Superior approach to the inferior laryngeal nerve in thyroid surgery: anatomy, surgical technique and indications. Surg Radiol Anat 2006;28:631–6CrossRefGoogle Scholar