Use of intraoperative neural monitoring for prognostication of recovery of vocal mobility and reduction of permanent vocal paralysis after thyroidectomy.

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Abstrakt

Tytuł:: Use of intraoperative neural monitoring for prognostication of recovery of vocal mobility and reduction of permanent vocal paralysis after thyroidectomy.
Autorzy:: Thong G; Department of Otolaryngology - Head and Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland.
Brophy C; Department of Otolaryngology - Head and Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland.
Sheahan P; Department of Otolaryngology - Head and Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland.; Ear Nose Throat and Oral (ENTO) Research Institute, University College Cork, Cork, Ireland.
Źródło:: Head & neck [Head Neck] 2021 Jan; Vol. 43 (1), pp. 7-14. Date of Electronic Publication: 2020 Aug 30.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: New York, NY : John Wiley And Sons
Original Publication: New York, NY : J. Wiley, c1989-
MeSH Terms:: Recurrent Laryngeal Nerve Injuries*/etiology
Recurrent Laryngeal Nerve Injuries*/prevention & control
Vocal Cord Paralysis*/etiology
Humans ; Monitoring, Intraoperative ; Prospective Studies ; Recurrent Laryngeal Nerve ; Retrospective Studies ; Thyroidectomy/adverse effects
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Contributed Indexing:: Keywords: branching; neural monitoring; recurrent laryngeal nerve; thyroidectomy; vocal palsy
Entry Date(s):: Date Created: 20200901 Date Completed: 20210621 Latest Revision: 20210621
Update Code:: 20240105
DOI:: 10.1002/hed.26440
PMID:: 32864795
: Czasopismo naukowe

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Introduction: The benefits of intraoperative neural monitoring (IONM) of recurrent laryngeal nerve (RLN) on post-thyroidectomy vocal cord palsy (VCP) rates are contentious. We wished to study impact of IONM on permanent VCP after thyroidectomy.
Methods: Retrospective review of prospective series of 1011 (1539 nerves-at-risk) patients undergoing thyroidectomy without (418, group 1) and with (583, group 2) IONM.
Results: There were three recognized nerve injuries in group 1, vs one in group 2 (P = .3). There were no differences in overall VCP rates. However, patients in group 2 with immediate postoperative VCP had higher likelihood of full recovery than patients in group 1 (55 of 56 vs 23 of 29 patients, P = .01), and lower incidence of total permanent VCP (2 of 917 vs 9 of 647 patients, P = .01).
Conclusion: Among patients with immediate postoperative VCP after thyroidectomy, IONM is associated with a higher likelihood of regaining normal vocal function. This may be related to better identification of RLN branching in IONM cases.
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