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  • Title: [Intraoperative neuromonitoring of the recurrent laryngeal nerve - results and learning curve].
    Author: Jonas J, Bähr R.
    Journal: Zentralbl Chir; 2006 Dec; 131(6):443-8. PubMed ID: 17206561.
    Abstract:
    Intraoperative neuromonitoring was introduced in thyroid surgery several years ago resulting in a facilitated identification of the recurrent laryngeal nerve and less recurrent laryngeal nerve injuries. Between 1999 and 2004 data of all patients (n=937) undergoing thyroid resection were recorded prospectively and analyzed yearly. The intraoperative identification of recurrent laryngeal nerve succeeded in 99.2% (1665 nerves at risk). The percentage of completely resecting surgical procedures raised from 17% to 56%. Minimal vocal cord dysfunction associated with hematoma and edema in most cases was diagnosed laryngosopically in 1.4-2.4%. Transient recurrent nerve palsies were seen in 2.3% without changes throughout the years. The permanent palsy rate of 0.8% in the first years decreased. No permanent palsies were diagnosed in the last 3 years. Routine introduction of intraoperative neuromonitoring in thyroid surgery is associated with a demonstrable learning curve lasting several years. Permanent palsy rate is decreased. The rate of minimal vocal cord movement disorders and transient recurrent laryngeal nerve palsies is not changed.
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