Postoperative vocal fold palsy in patients undergoing thyroid surgery with continuous or intermittent nerve monitoring

The British Journal of Surgery
Rick SchneiderHenning Dralle

Abstract

Continuous monitoring of electromyographic (EMG) amplitudes of the vocal muscles detects impending injury of the recurrent laryngeal nerve (RLN) during thyroid operations earlier than intermittent EMG monitoring. This may alert the surgeon to stop a manoeuvre causing stretching or pressure on the RLN, with better recovery of nerve function. Patients with intact preoperative RLN function who underwent thyroid surgery for benign disease between January 2011 and September 2014 under continuous intraoperative nerve monitoring (CIONM) or intermittent intraoperative nerve monitoring (IIONM) were included in this observational study conducted at a tertiary surgical centre. For CIONM, combined EMG events indicative of imminent nerve injury were defined as an EMG amplitude decrease of 50 per cent or more and a latency increase of 10 per cent relative to baseline values. The rates of early and permanent palsy for the two groups of patients were compared. There were 1526 patients, 788 of whom (1314 nerves at risk) underwent thyroid surgery using CIONM and 738 (965 nerves at risk) had IIONM. With the use of CIONM, 63 (82 per cent) of 77 combined events were reversible during the operation. No permanent vocal fold palsy occurred with CIONM,...Continue Reading

References

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Citations

Feb 2, 2016·Head & Neck·Martin AlmquistFarhad Salem
Jun 24, 2015·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·H DralleA Machens
May 5, 2016·Langenbeck's Archives of Surgery·Małgorzata Stopa, Marcin Barczyński
Aug 19, 2016·The British Journal of Surgery·A BergenfelzUNKNOWN Steering Committee for the Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal Surgery (SQRTPA)
Jan 29, 2017·International Journal of Surgery·Shuwen YangYu Wang
Mar 14, 2018·The British Journal of Surgery·R SchneiderH Dralle
Nov 8, 2017·Langenbeck's Archives of Surgery·Aitor De la Quintana BasarrateIzaskun Yurrebaso Santamaría
Nov 22, 2018·Intensive Care Medicine·Zhengshang RuanLai Jiang
Aug 3, 2019·The Laryngoscope·Geir Olav DahleKatrin Brauckhoff
Mar 11, 2020·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Daqi ZhangGianlorenzo Dionigi
Sep 2, 2016·Current Opinion in Endocrinology, Diabetes, and Obesity·Ivy H GardnerDavid McAneny
Jun 21, 2019·Annals of the Royal College of Surgeons of England·E O GürY Kumkumoglu
Jun 4, 2017·Oral and Maxillofacial Surgery·Sameep KadakiaYadranko Ducic
May 28, 2019·Journal of Endocrinological Investigation·M N MinutoE Varaldo
Jul 28, 2020·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·F Weber, H Dralle
Sep 13, 2018·Updates in Surgery·Hui SunGianlorenzo Dionigi
Sep 23, 2018·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·R SchneiderJ Ukkat
Jan 29, 2020·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Petar StankovicThomas Günzel
Mar 26, 2020·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Yishen ZhaoHui Sun
May 11, 2018·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Daqi ZhangHui Sun
Dec 22, 2020·Facial Plastic Surgery & Aesthetic Medicine·Kasra ZiaiJessyka G Lighthall
Aug 4, 2021·Head & Neck·Dominic KuGregory Randolph

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