THE VALUE OF NEURO STIMULATION WITH LARYNGEAL PALPATION (NSLP) AND INTRAOPERATIVE NERVE MONITORING (IONM) OF RECURRENT LARYNGEAL NERVE IN THYROID SURGERY

Dr. Tanvir Hussain, Dr. Hadi Al-Hakami, Dr. Mohammed Al Garni
2018 Zenodo  
Objective: To compare the accuracy of utilizing neuro stimulation with laryngeal palpation (NSLP) and intraoperative neuro monitoring (CIONM) in total thyroidectomy with regards to injury to the recurrent laryngeal nerve. Methods: A retrospective historical cohort study was carried out during the period between January 2014 and January 2018 in King Abdul Aziz Medical, Jeddah. A total of 260 cases that underwent total thyroidectomy were evaluated for recurrent laryngeal nerve injury. The injury
more » ... injury. The injury rate in these cases was compared between cases done with continuous intraoperative nerve monitoring (group 1; n = 115) and those performed using neuro stimulation with laryngeal palpation (group 2; n = 145). Results: There was no significant difference in nerve injury between cases done with intraoperative nerve monitoring and those with neuro stimulation with laryngeal palpation (P = 0.25). The presence or absence of laryngeal twitch (LT) (P < 0.001) and the acoustic response to electrical stimulation (P = 0.03) were significantly associated with nerve function at the end of the surgery. Conclusion: Our results indicate that NSLP is a safe and reliable intraoperative method of RLN monitoring. Moreover, our data confirm that IONM is not significantly better than NSLP to reduce the rate of permanent RLNI in thyroid surgery. Keywords: Thyroidectomy, Neuro stimulation, Laryngeal Palpation, Intraoperative Nerve Monitoring, Vocal Cord Palsy, Recurrent Laryngeal Nerve Injury.
doi:10.5281/zenodo.1549711 fatcat:ao2vokfwrnb6dcxsia3renjhom