Intraoperative nerve monitoring is associated with a lower risk of recurrent laryngeal nerve injury: A national analysis of 17,610 patients |
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| Authors: | Jina Kim Claire E Graves Chengshi Jin Quan-Yang Duh Jessica E Gosnell Wen T Shen Insoo Suh Julie A Sosa Sanziana A Roman |
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| Institution: | 1. Department of Surgery, University of California, San Francisco, USA;2. Department of Epidemiology and Biostatistics, University of California, San Francisco, USA;1. Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA, USA;2. Department of General Surgery, Massachusetts General Hospital, Boston, MA, USA;3. Amherst H. Wilder Foundation, Saint Paul, MN, USA;4. Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, MA, USA;1. Department of Surgery, Mayo Clinic, 200th 1st Street, Rochester MN, 55905, USA;2. Department of Health Services Research, Mayo Clinic, 200th 1st Street, Rochester MN, 55905, USA;3. Mayo Clinic Robert D and Patricia E Kern Center for the Science of Health Care Delivery, 200th 1st Street, Rochester MN, 55905, USA;1. Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA;2. Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA |
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| Abstract: | BackgroundBased on current evidence, the benefit of intraoperative nerve monitoring (IONM) in thyroid surgery is equivocal.MethodsAll patients who underwent planned thyroid surgery in the 2016–2018 ACS NSQIP procedure-targeted thyroidectomy dataset were included. Multivariable regression analyses were performed to examine the association between nerve monitoring and recurrent laryngeal nerve (RLN) injury while adjusting for patient demographics, extent of surgery, and perioperative variables.ResultsIn total, 17,610 patients met inclusion criteria: 77.8% were female, and the median age was 52 years. IONM was used in 63.9% of cases. Of the entire cohort, 6.1% experienced RLN injury. Cases with IONM use had a lower rate of RLN injury compared to those that did not use IONM (5.7% vs. 6.8%, p = 0.0001). After adjustment, IONM was associated with reduced risk of RLN injury (OR 0.69, 95% CI 0.59–0.82, p < 0.0001).ConclusionsNationally, IONM is used in nearly two thirds of thyroid surgeries. IONM is associated with a lower risk of recurrent laryngeal nerve injury. |
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| Keywords: | Thyroidectomy Recurrent laryngeal nerve Intraoperative nerve monitoring |
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