Thyroid Surgery Guided by Intraoperative Neuromonitoring
From its humble beginnings 150 years ago, thyroid surgery not only endeavored to resect thyroid disease but at the same time strove to preserve those structures adjacent to the thyroid gland that are of utmost importance physiologically and for maintenance of quality of life: recurrent laryngeal nerves (RLN) and parathyroid glands. Postoperative RLN palsy and postoperative hypoparathyroidism, more than recurrence of thyroid disease, were to become key performance indicators of the quality of thyroid surgery.
For decades, the chief controversy in thyroid surgery in general and for RLN management in particular revolved around preservation of the nerve through visual identification. This is not surprising given the nerve’s unique vulnerability and anatomic course which closely approximates the line of resection during thyroidectomy.
KeywordsRecurrent Laryngeal Nerve Vagus Nerve Stimulation Thyroid Surgery Recurrent Laryngeal Nerve Palsy Vocal Cord Function
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