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World Journal of Surgery

, Volume 42, Issue 2, pp 451–452 | Cite as

Modification of the Surgical Strategy for the Dissection of the Recurrent Laryngeal Nerve Using Continuous Intraoperative Nerve Monitoring

  • Stan Sidhu
Invited Commentary

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 [1]. 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 [2]. 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...

References

  1. 1.
    Marin Arteaga A, Peloni G, Leuchter I et al (2017) Modification of the surgical strategy for the dissection of the recurrent laryngeal nerve using continuous intraoperative nerve monitoring. World J Surg.  https://doi.org/10.1007/s00268/017-4277-z PubMedGoogle Scholar
  2. 2.
    Lee J, Fraser S, Glover A et al (2016) Prospective evaluation of the utility of routine neuromonitoring for an established thyroid surgical practice. ANZ J Surg.  https://doi.org/10.1111/ans.13606 Google Scholar
  3. 3.
    Proye CAG (1993) Substernal goitre. Surgical technique. Curr Pract Surg 5:72–77Google Scholar
  4. 4.
    Anuwong A, Ketwong K, Jitpratoom P et al (2017) Safety and outcomes of the transoral endoscopic thyroidectomy vestibular approach. JAMA Surg.  https://doi.org/10.1001/jamasurg.2017.3366 PubMedGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2017

Authors and Affiliations

  1. 1.Endocrine Surgical UnitUniversity of SydneySt LeonardsAustralia

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