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Keywords = intraoperative neuromonitoring (I-IONM)

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9 pages, 506 KiB  
Article
The Application of Intermittent Intraoperative Neuromonitoring (I-IONM) and Continuous Intraoperative Neuromonitoring (C-IONM) During Thyroid Surgery: A Single-Center Study
by Bruno Cirillo, Gioia Brachini, Giuseppe Cavallaro, Mariarita Tarallo, Cecilia Carlino, Giulia Duranti, Martina Zambon, Andrea Mingoli, Luigi Simonelli and Marco Bononi
J. Clin. Med. 2025, 14(8), 2612; https://doi.org/10.3390/jcm14082612 - 10 Apr 2025
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Abstract
Background: The application of intermittent intraoperative neuromonitoring (I-IONM) and continuous intraoperative neuromonitoring (C-IONM) has been widely accepted to improve surgical outcomes after thyroid surgery. This observational study aimed to evaluate the impact of vocal cord paralysis (VCP) in thyroid surgery conducted with I-IONM [...] Read more.
Background: The application of intermittent intraoperative neuromonitoring (I-IONM) and continuous intraoperative neuromonitoring (C-IONM) has been widely accepted to improve surgical outcomes after thyroid surgery. This observational study aimed to evaluate the impact of vocal cord paralysis (VCP) in thyroid surgery conducted with I-IONM and C-IONM. Materials and Methods: From January 2018 to December 2022, 147 patients operated on with I-IONM and C-IONM for thyroid surgery were analyzed. Variations in the rates of the occurrence of temporary and permanent vocal cord paralysis between the two groups were compared. A p-value < 0.05 was considered statistically significant. Results: In total, 147 patients were eligible for inclusion in the study. Of these, 96 (65%) patients underwent thyroid surgery with I-IONM, 52 patients (35%) underwent surgery with C-IONM by a single surgeon. The percentage of temporary VCP was 4.1% (4 patients) in the I-IONM group; no patients had permanent VCP. In the C-IONM group, two patients (3.9%) had permanent vocal cord paralysis, and temporary vocal cord paralysis was observed in other two patients (3.9%), who recovered their nerve function after speech therapy. No statistically significant differences were found in the two groups. Conclusions: In our study, both I-IONM and C-IONM proved effective in predicting VCP, and no significant differences were observed between the two techniques in our series. Full article
(This article belongs to the Special Issue Endocrine Malignancies: Current Surgical Therapeutic Approaches)
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11 pages, 424 KiB  
Systematic Review
Intraoperative Neuromonitoring Does Not Reduce the Risk of Temporary and Definitive Recurrent Laryngeal Nerve Damage during Thyroid Surgery: A Systematic Review and Meta-Analysis of Endoscopic Findings from 73,325 Nerves at Risk
by Anna Teresa Cozzi, Alice Ottavi, Paolo Lozza, Alberto Maccari, Roberto Borloni, Letizia Nitro, Elena Giulia Felisati, Andrea Alliata, Barbara Martino, Giancarlo Cacioppo, Manuela Fuccillo, Cecilia Rosso, Carlotta Pipolo, Giovanni Felisati, Loredana De Pasquale and Alberto Maria Saibene
J. Pers. Med. 2023, 13(10), 1429; https://doi.org/10.3390/jpm13101429 - 23 Sep 2023
Cited by 11 | Viewed by 2188
Abstract
Background: While intraoperative neuromonitoring (IONM) helps the early identification of recurrent laryngeal nerve (RLN) damage, IONM’s role in RLN damage prevention is not defined, given the lack of large studies on the subject. Methods: In a PRISMA-compliant framework, all original thyroid surgery prospective [...] Read more.
Background: While intraoperative neuromonitoring (IONM) helps the early identification of recurrent laryngeal nerve (RLN) damage, IONM’s role in RLN damage prevention is not defined, given the lack of large studies on the subject. Methods: In a PRISMA-compliant framework, all original thyroid surgery prospective studies providing early postoperative endoscopic data for all patients were pooled in a random-effects meta-analysis. We compared the temporary (and definitive where available) RLN damage rates according to IONM use and IONM type (intermittent, I-IONM, or continuous, C-IONM). Results: We identified 2358 temporary and 257 definitive RLN injuries in, respectively, 73,325 and 66,476 nerves at risk. The pooled temporary and definitive RLN injury rates were, respectively, 3.15% and 0.422% considering all procedures, 3.29% and 0.409% in cases using IONM, and 3.16% and 0.463 in cases not using IONM. I-IONM and C-IONM, respectively, showed a pooled temporary RLN injury rate of 2.48% and 2.913% and a pooled definitive injury rate of 0.395% and 0.4%. All pooled rates had largely overlapping 95% confidence intervals. Conclusions: Our data suggest that IONM does not affect the temporary or definitive RLN injury rate following thyroidectomy, though its use can be advised in selected cases and for bilateral palsy prevention. Full article
(This article belongs to the Section Mechanisms of Diseases)
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