Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 6-11 |
| Number of pages | 6 |
| Journal | Journal of Clinical and Translational Endocrinology |
| Volume | 15 |
| DOIs | |
| Publication status | Published - 2019 Mar 1 |
| Externally published | Yes |
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Keywords
- Graves’ disease
- Morbidity
- Neural monitoring
- Recurrent laryngeal nerve
- Thyroid surgery
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
- Endocrinology
Cite this
How does neural monitoring help during thyroid sugery for Graves’ disease? / Zhou, Le; Dionigi, Gianlorenzo; Pontin, Alessandro; Pino, Antonella; Caruso, Ettore; Wu, Che Wei; Sun, Hui; Tufano, Ralph P.; Kim, Hoon Yub.
In: Journal of Clinical and Translational Endocrinology, Vol. 15, 01.03.2019, p. 6-11.Research output: Contribution to journal › Article
}
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 - 2019/3/1
Y1 - 2019/3/1
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 -