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Utility of intraoperative nerve monitoring in thyroid surgery: 20-year experience with 1418 cases

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Abstract

Purpose

The efficacy of intraoperative nerve monitoring is controversial in the literature. This study of a single surgeon’s experience seeks to determine if the use of intraoperative nerve monitoring influences recurrent laryngeal nerve injury during thyroid surgery.

Methods

Six hundred fifty-seven patients with normal pre-operative vocal fold function underwent thyroid surgery without the use of intraoperative nerve monitoring from September 1997 to January 2007, while 761 patients underwent thyroid surgery from February 2007 to February 2016 with routine use of nerve monitoring. Patients were followed for a minimum of 6 months after surgery, and postoperative nerve function was determined by fiberoptic laryngoscopy. A Fisher test was used to determine if nerve injury was statistically different between both groups.

Results

In patients operated on without nerve monitoring, 21 patients were found to have postoperative vocal fold paralysis with nine regaining functioning. In patients operated on with nerve monitoring, 27 were found to have vocal fold dysfunction with 17 regaining function. Fisher test analysis, both with and without patients regaining function, showed no difference in nerve injury between groups (p > 0.05, p > 0.05).

Conclusion

Intraoperative monitoring during thyroidectomy may not prevent injury to the recurrent laryngeal nerve.

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Acknowledgements

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Authors and Affiliations

  1. New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA

    Sameep Kadakia & Shirley Hu

  2. Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, TX, USA

    Moustafa Mourad & Yadranko Ducic

  3. Kaiser Permanente, Denver, CO, USA

    Ryan Brown

  4. Virginia Commonwealth University Medical Center, Richmond, VA, USA

    Thomas Lee

Authors
  1. Sameep Kadakia
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  2. Moustafa Mourad
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  3. Shirley Hu
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  4. Ryan Brown
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Correspondence to Sameep Kadakia.

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The authors declare that they have no conflict of interest.

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Kadakia, S., Mourad, M., Hu, S. et al. Utility of intraoperative nerve monitoring in thyroid surgery: 20-year experience with 1418 cases. Oral Maxillofac Surg 21, 335–339 (2017). https://doi.org/10.1007/s10006-017-0637-y

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  • DOI: https://doi.org/10.1007/s10006-017-0637-y

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