Utility of the continuous intraoperative neuromonitoring in the prevention of the recurrent laryngeal nerve paralysis during thyroid surgery. A prospective observational study |
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| Affiliation: | 1. Endocrine Surgery Unit, Complejo Hospitalario de Navarra, Pamplona, Spain;2. Nuclear Medicine Department. Complejo Hospitalario de Navarra, Pamplona, Spain;1. Colorectal Surgery Department at Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain;2. General Surgery Department, Hospital Universitario Arnau de Vilanova, Lleida, Spain;3. Thoracic Surgery Department, Hospital Universitario Arnau de Vilanova, Lleida, Spain;4. Universidad de Lleida, Spain;5. Hospital Clínico Universitario de Vigo, Vigo, Spain;6. Internal Medicine, Hospital Universitario Arnau de Vilanova, Lleida, Spain;7. Physiatrist. Hospital Universitario Arnau de Vilanova, Lleida, Spain;8. Oncological Nurseh. Hospital Universitario Arnau de Vilanova, Lleida, Spain;1. Unidad de Trauma y Cirugía de Urgencias, Complexo Hospitalario Universitario A Coruña, La Coruña, España;2. Angiología y Cirugía Vascular, Hospital QuirónSalud, La Coruña, España |
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| Abstract: | BackgroundThe continuous intraoperative neuromonitoring (C-IONM) of the recurrent laryngeal nerve (RLN) could help reducing the incidence of nerve paralysis after thyroid surgery, in comparison with the mere anatomical visualization of the RLN. The objective is to assess the efficacy and utility of C-IONM as a predictive test for recurrent laryngeal nerve paralysis after thyroidectomy.MethodsA prospective observational study was performed in 248 patients who underwent thyroid surgery where C-IONM was applied, between September 2018 and December 2019, in a high-volume center. A previous and later laryngoscopy was performed, which allowed to evaluate the reliability of the C-IONM as a predictive test for recurrent paralysis. Sensitivity (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPV) were studied.ResultsA total number of 171 thyroidectomies, 62 hemithyroidectomies, 15 totalization thyroidectomies and 27 thyroidectomy with cervical dissections were performed. Postoperative laryngoscopy was altered in 40 patients (16.12%). The SE, SP, PPV and NPV values were 65%, 94.7%, 70.2% and 93.4% respectively.ConclusionsC-IONM is a safe technique that provides real-time information about anatomical and functional integrity of the RLN and can improve the results of thyroid surgery. |
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| Keywords: | Continuous intraoperative neuromonitoring Recurrent laryngeal nerve Vocal cord paralysis Thyroid surgery Neuromonitorización continua intraoperatoria Nervio laríngeo recurrente Parálisis de cuerda vocal Cirugía tiroidea |
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