How does neural monitoring help during thyroid sugery for Graves' disease?
- Authors
- Zhou, Le; Dionigi, Gianlorenzo; Pontin, Alessandro; Pino, Antonella; Caruso, Ettore; Wu, Che-Wei; Sun, Hui; Tufano, Ralph P.; Kim, Hoon Yub
- Issue Date
- 3월-2019
- Publisher
- ELSEVIER SCIENCE BV
- Keywords
- Thyroid surgery; Graves' disease; Neural monitoring; Recurrent laryngeal nerve; Morbidity
- Citation
- JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY, v.15, pp.6 - 11
- Indexed
- SCOPUS
- Journal Title
- JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY
- Volume
- 15
- Start Page
- 6
- End Page
- 11
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/67147
- DOI
- 10.1016/j.jcte.2018.11.002
- ISSN
- 2214-6237
- Abstract
- 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.
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