TY - JOUR
T1 - How does neural monitoring help during thyroid sugery for Graves’ disease?
AU - Zhou, Le
AU - Dionigi, Gianlorenzo
AU - Pontin, Alessandro
AU - Pino, Antonella
AU - Caruso, Ettore
AU - Wu, Che Wei
AU - Sun, Hui
AU - Tufano, Ralph P.
AU - Kim, Hoon Yub
PY - 2019/3
Y1 - 2019/3
N2 - We evaluate the role of intraoperative neuromonitoring (IONM) in thyroidectomy performed for Graves’ disease (GD) with an emphasis on recurrent laryngeal nerve (RLN) management and completeness of resection. The study is a retrospective series comprising 55 thyroidectomy (control group) versus 82 procedures with intermittent IONM (I-IONM) and 72 by means of continuous IONM (C-IONM). In the control group the laryngeal nerves have been identified by visualization solely. In the I-IONM group both vagal nerve (VN) and RLN have been localized and monitored during thyroid resection. C-IONM was achieved with a vagal stimulation probe. I-IONM group had shorter operating times (P = 0.032). RLN morbidity, meaning palsy rate, was 2.7% in the C-IONM group, 3.6% in I-IONM and 5.4% in the control group (P = 0.058). The proportion of complete procedures (total or near total resections) were significantly higher using monitoring technology (P = 0.049). Persistent positive serum TBII values were found in 25 (45%), 25 (30%) and 20 (27%) patients at 12 months in the control, I-IONM and C-IONM groups respectively (P = 0,04). IONM is an effective technology in GD patients.
AB - We evaluate the role of intraoperative neuromonitoring (IONM) in thyroidectomy performed for Graves’ disease (GD) with an emphasis on recurrent laryngeal nerve (RLN) management and completeness of resection. The study is a retrospective series comprising 55 thyroidectomy (control group) versus 82 procedures with intermittent IONM (I-IONM) and 72 by means of continuous IONM (C-IONM). In the control group the laryngeal nerves have been identified by visualization solely. In the I-IONM group both vagal nerve (VN) and RLN have been localized and monitored during thyroid resection. C-IONM was achieved with a vagal stimulation probe. I-IONM group had shorter operating times (P = 0.032). RLN morbidity, meaning palsy rate, was 2.7% in the C-IONM group, 3.6% in I-IONM and 5.4% in the control group (P = 0.058). The proportion of complete procedures (total or near total resections) were significantly higher using monitoring technology (P = 0.049). Persistent positive serum TBII values were found in 25 (45%), 25 (30%) and 20 (27%) patients at 12 months in the control, I-IONM and C-IONM groups respectively (P = 0,04). IONM is an effective technology in GD patients.
KW - Graves’ disease
KW - Morbidity
KW - Neural monitoring
KW - Recurrent laryngeal nerve
KW - Thyroid surgery
UR - http://www.scopus.com/inward/record.url?scp=85056890843&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85056890843&partnerID=8YFLogxK
U2 - 10.1016/j.jcte.2018.11.002
DO - 10.1016/j.jcte.2018.11.002
M3 - Article
AN - SCOPUS:85056890843
VL - 15
SP - 6
EP - 11
JO - Journal of Clinical and Translational Endocrinology
JF - Journal of Clinical and Translational Endocrinology
SN - 2214-6237
ER -