Objective: This research was aimed to investigate whether the intraoperative nerve monitoring (IONM) can reduce the incidence of recurrent laryngeal nerve (RLN) injury in geriatric patients undergoing thyroid surgery.
Methods: This retrospective cohort study included 522 geriatric patients undergoing thyroid surgery between January 2013 and June 2016 in the Sun Yat-sen Memorial Hospital. Patients with IONM during the surgery (n = 340) were compared with patients without IONM (n = 212). RLN injury was verified by direct or indirect laryngoscope and relative factors for injury would be retrospectively analyzed.
Results: The use of IONM group showed significant reduction in both total and transient RLN injury incidence, when compared with that in control group (1.76 versus 4.72%, p = .01 and 1.32 versus 3.67%, p = .03, respectively). However, the permanent RLN injury incidence did not show difference between the two groups (p = .3).
Conclusions: Our finding showed the use of IONM resulted in significantly reduction in RLN injury incidence. The technology of IONM is safe and convenient to detect, track and monitor the complete function of RLN and to provide the guidance for the surgeons during the thyroid surgery in geriatric patients, who are at high risk of RLN injury.
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http://dx.doi.org/10.1080/00016489.2017.1354397 | DOI Listing |
J Thorac Dis
December 2024
Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, China.
Background: Minimally invasive esophagectomy (MIE) can lead to a severe complication known as recurrent laryngeal nerve paralysis (RLNP). Existing literature supports that recurrent laryngeal nerve (RLN) injury is the principal etiology of RLNP, a complication potentially mitigated through intraoperative neuromonitoring (IONM). In this study, we examined the comprehensive effectiveness of IONM during esophageal resection by performing a meta-analysis.
View Article and Find Full Text PDFJAMA Otolaryngol Head Neck Surg
January 2025
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Importance: Intraoperative nerve monitoring (IONM) is not considered standard of care during thyroidectomy, and guidelines are vague about its use in the absence of strong evidence of superiority over visualization of the recurrent laryngeal nerve (RLN) alone.
Objective: To characterize patterns of IONM use during thyroidectomy in the US and evaluate the association of IONM with postoperative outcomes.
Design, Setting, And Participants: This cohort study used the National Surgical Quality Improvement Program (NSQIP) thyroidectomy data from January 1, 2016, to December 31, 2022.
Updates Surg
January 2025
1St Propaedeutic Surgical Department, University Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki (AUTH), 5462, Thessaloniki, Greece.
The unprecedented technical and technological evolution in thyroid surgery has labelled it as an extremely safe and efficient procedure, and indeed "typifies perhaps better than any other operation the supreme triumph of the surgeon's art."-William Halsted, 1852-1922. Surgeon's experience reflected by annual case load is the most important denominator in thyroid surgery.
View Article and Find Full Text PDFDiagnostics (Basel)
December 2024
Department of ENT and Head and Neck Surgery, University Hospital Center Zagreb, 10000 Zagreb, Croatia.
: Thyroidectomy, a surgical procedure for thyroid disorders, is associated with postoperative voice changes, even in cases without recurrent laryngeal nerve (RLN) injury. Our study evaluates the prevalence and predictors of voice disorders in thyroidectomy patients without RLN injury. : Our single-center prospective study at the University Hospital Center Zagreb included 243 patients, with pre- and postoperative voice evaluations using acoustic analysis and videostroboscopy.
View Article and Find Full Text PDFJ Pediatr Surg
December 2024
Rady Children's Hospital San Diego, 3020 Children's Way, San Diego, CA 92123, USA; University of California San Diego School of Medicine, Department of Surgery, 9500 Gilman Dr., La Jolla, CA 92093, USA. Electronic address:
Background: Thoracoscopic repair of esophageal atresia with tracheoesophageal fistula (EA/TEF) has been reported to have superior outcomes to the open approach. We sought to evaluate adoption of thoracoscopic repair at US children's hospitals and compare outcomes to open repair.
Methods: The Pediatric Health Information System database was used to identify patients with EA/TEF who underwent repair between 2016 and 2023.
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