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Surg Technol Int. 2019 Jan 18;34. pii: sti34/1070. [Epub ahead of print]

New Paradigms for Neural Monitoring in Thyroid Surgery.

Author information

1
Division of Thyroid Surgery, China-Japan Union Hospital Of Jilin University Jilin Provincial Key Laboratory Of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun,Jilin province, PR China.
2
Department of Otorhinolaryngology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University Hospital; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
3
Division of Endocrine Surgery, Department of Surgery, Ege University Hospital Ege University-Izmir, Turkey.
4
Division of Thyroid Surgery, China-Japan Union, Hospital Of Jilin University Jilin Provincial Key Laboratory Of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun, Jilin province, PR China.
5
Department of Surgery, S. Anna University Hospital, Ferrara, Italy and Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy.
6
Department Of Surgery, Korea University College of Medicine, Seoul, Korea.
7
Division for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital G. Martino, University of Messina, Messina, Italy.
8
Division for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood "G. Barresi" University Hospital G. Martino, University of Messina, Messina, Italy.
9
Ospedale di Circolo di Varese, Varese, Italy.

Abstract

Intraoperative neuromonitoring (IONM) in thyroid gland surgery provides real-time feedback to the endocrine surgeon regarding the electrophysiological consequences of surgical manipulation of the laryngeal nerves. The goal of monitoring modalities is to detect surgical or physiological insults to the recurrent laryngeal nerve (RLN) while they are still reversible or, in cases where prevention is not an option, to minimize the damage done to these structures during thyroidectomy. In recent decades, monitoring of the RLN has become a fundamental part of endocrine surgery. IONM is a feasible procedure in both open and endoscopic, robotic thyroidectomy. Experts in IONM have organized a working group of general, endocrine, head and neck ENT surgeons and endocrinologists (International Neural Monitoring Study Group; INMSG) to develop standards for practicing this technique in endoscopic and robotic thyroidectomy. This paper presents recent clinical and research experience with intraoperative neural monitoring for thyroid gland surgery.

PMID:
30664223

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