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.
How does neural monitoring help during thyroid sugery for Graves’ disease? / L. Zhou, G. Dionigi, A. Pontin, A. Pino, E. Caruso, C. Wu, H. Sun, R.P. Tufano, H.Y. Kim. - In: JOURNAL OF CLINICAL & TRANSLATIONAL ENDOCRINOLOGY. - ISSN 2214-6237. - 15(2018), pp. 6-11. [10.1016/j.jcte.2018.11.002]
|Titolo:||How does neural monitoring help during thyroid sugery for Graves’ disease?|
DIONIGI, GIANLORENZO (Corresponding)
|Settore Scientifico Disciplinare:||Settore MED/18 - Chirurgia Generale|
|Data di pubblicazione:||2018|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.jcte.2018.11.002|
|Appare nelle tipologie:||01 - Articolo su periodico|