What is it about?
This article presents a systematic review and meta-analysis that investigates the role of intraoperative neuromonitoring (IONM) in reducing the risk of recurrent laryngeal nerve (RLN) damage during thyroid surgery. RLN damage is one of the most common complications associated with thyroidectomy and can lead to voice-related complications such as hoarseness and dysphonia. The study evaluates the available evidence by analyzing a large number of prospective studies that provide early postoperative endoscopic data on RLN injuries.
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Why is it important?
Thyroid surgery carries the risk of RLN damage, which can significantly impact patients' quality of life. Intraoperative neuromonitoring has been introduced as a potential tool to aid in the identification and protection of the RLN during surgery. However, the effectiveness of IONM in preventing RLN damage remains uncertain due to limited high-evidence studies. This systematic review addresses this knowledge gap by pooling data from a substantial number of studies and comparing RLN injury rates between procedures with and without IONM. The findings of this study have important implications for clinical practice. The analysis suggests that IONM does not significantly affect the temporary or definitive RLN injury rates following thyroidectomy. However, it also highlights that IONM may still be beneficial in selected cases and for preventing bilateral vocal cord paralysis. These results contribute valuable insights for surgeons, enabling them to make informed decisions regarding the use of IONM during thyroid surgery.
Perspectives
The debate surrounding the role of intraoperative neuromonitoring in RLN damage prevention during thyroid surgery continues. While this study suggests that IONM does not significantly reduce RLN injury rates, it emphasizes the need for further investigation and more high-quality studies. The complexity of RLN anatomy and the variability in surgical techniques make it challenging to draw definitive conclusions. Future research should focus on identifying patient subgroups that may benefit most from IONM and refining the techniques to enhance its effectiveness. Ultimately, the goal is to improve patient outcomes and minimize the risk of RLN-related complications in thyroid surgery.
Dr alberto maria saibene
Universita degli Studi di Milano
Read the Original
This page is a summary of: 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, Journal of Personalized Medicine, September 2023, MDPI AG,
DOI: 10.3390/jpm13101429.
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