Modification of the Surgical Strategy for the Dissection of the Recurrent Laryngeal Nerve Using Continuous Intraoperative Nerve Monitoring
The manuscript by Arteaga and colleagues from the Endocrine Surgery Unit of the University Hospitals of Geneva highlights several pertinent issues regarding the preservation of the function of the recurrent laryngeal nerve during thyroid surgery . Their Unit has routinely used intermittent intraoperative neuromonitoring (I-IONM) since 2008 and has prospectively documented their experience with continuous intraoperative neuromonitoring (C-IONM) in selected difficult cases since 2012 including redo surgery, thyroid cancer surgery, large retrosternal goitres and Graves’ disease. It behoves all surgeons undertaking the use of new technology to prospectively document their own outcomes in order to validate the technology in their hands . Having achieved a low recurrent laryngeal nerve palsy (RLNP) rate utilising I-IONM of 2.8% at the end of thyroidectomy and 1.4% confirmed at laryngoscopy on Day 1 post-surgery, 0.8% at 3 months and 0.06% permanent injury at 6 months, the authors are...
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