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Intermittent Neuromonitoring of the Recurrent Laryngeal and Vagus Nerves: the Ins and Outs

  • Nerve Monitoring in Head and Neck Surgery (C Sinclair, Section Editor)
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Abstract

Purpose of Review

Intermittent intraoperative nerve monitoring has remained a controversial topic in endocrine neck surgery as several studies have produced nonuniform results. Although continuous intraoperative nerve monitoring is a newer technology, intermittent monitoring is still a useful adjunct in safe thyroid surgery when used correctly. This work summarizes the benefits, limitations, setup, and troubleshooting techniques for this technology.

Recent Findings

There are randomized controlled trials and meta-analyses supporting the use of intermittent neuromonitoring in thyroid surgery, but it has not been consistently demonstrated to improve outcomes compared to the gold standard of nerve visualization alone.

Summary

Although intermittent neuromonitoring has not been consistently shown to reduce rates of vocal cord paralysis, it is particularly useful in intraoperative neural identification, nerve dissection, and neural prognostication to prevent bilateral vocal cord paralysis. Future research may further compare outcomes between use of intermittent and continuous neuromonitoring in thyroid surgery.

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  1. Department of Otolaryngology – Head and Neck Surgery, Division of Endocrine Surgery, Emory University School of Medicine, 550 Peachtree Street, Medical Office Tower, Suite 1135, Atlanta, GA, 30308, USA

    Micah M. Gibson & Amy Y. Chen

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Correspondence to Amy Y. Chen.

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Gibson, M.M., Chen, A.Y. Intermittent Neuromonitoring of the Recurrent Laryngeal and Vagus Nerves: the Ins and Outs. Curr Otorhinolaryngol Rep 9, 316–325 (2021). https://doi.org/10.1007/s40136-021-00351-9

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