Use of intraoperative neural monitoring for prognostication of recovery of vocal mobility and reduction of permanent vocal paralysis after thyroidectomy
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Date
2020-08-30
Authors
Thong, Gerard
Brophy, Catherine
Sheahan, Patrick
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Publisher
John Wiley & Sons, Inc.
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Abstract
Introduction: The benefits of intraoperative neural monitoring (IONM) of recurrent laryngeal nerve (RLN) on post-thyroidectomy vocal cord palsy (VCP) rates are contentious. We wished to study impact of IONM on permanent VCP after thyroidectomy. Methods: Retrospective review of prospective series of 1011 (1539 nerves-at-risk) patients undergoing thyroidectomy without (418, group 1) and with (583, group 2) IONM. Results: There were three recognized nerve injuries in group 1, vs one in group 2 (P =.3). There were no differences in overall VCP rates. However, patients in group 2 with immediate postoperative VCP had higher likelihood of full recovery than patients in group 1 (55 of 56 vs 23 of 29 patients, P =.01), and lower incidence of total permanent VCP (2 of 917 vs 9 of 647 patients, P =.01). Conclusion: Among patients with immediate postoperative VCP after thyroidectomy, IONM is associated with a higher likelihood of regaining normal vocal function. This may be related to better identification of RLN branching in IONM cases.
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Keywords
Branching , Neural monitoring , Recurrent laryngeal nerve , Thyroidectomy , Vocal palsy
Citation
Thong, G., Brophy, C. and Sheahan, P. (2020) 'Use of intraoperative neural monitoring for prognostication of recovery of vocal mobility and reduction of permanent vocal paralysis after thyroidectomy', Head and Neck. doi: 10.1002/hed.26440
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© 2020, John Wiley & Sons, Inc. This is the peer reviewed version of the following article: Thong, G., Brophy, C. and Sheahan, P. (2020) 'Use of intraoperative neural monitoring for prognostication of recovery of vocal mobility and reduction of permanent vocal paralysis after thyroidectomy', Head and Neck, doi: 10.1002/hed.26440, which has been published in final form at https://doi.org/10.1002/hed.26440. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.