Intraoperative Neurophysiological Monitoring in Thyroid Operations as a Method of Reducing Neurological Deficit

Abstract

Introduction. Intraoperative neuromonitoring consists in current stimulation of the laryngeal nerve located near the thyroid gland. The intensity is usually set in the range of 1–2 mA in order to give the desired effect, but also to give the selectivity of the controlled nerves. The charge is designed to stimulate the vocal cords and motor innervation within the larynx, especially in the area of tissues subjected to surgery.

Aim. The aim of the study was to present intraoperative monitoring of the recurrent laryngeal nerve as a method of reducing the incidence of side effects associated with damage to the laryngeal nerve and to compare the quality of life of patients who were neuromonitored during procedures with those who underwent surgery without the use of intraoperative neuromonitoring.

Material and Methods. The study was conducted in two research groups. The first group consisted of 100 patients from CentroMedica Sp. z o. o. from all over Poland, who underwent surgery to remove a thyroid tumor with the help of neuromonitoring. The second research group consisted of 100 patients of the same company. They also underwent thyroid tumor excision, but in their case without the use of neuromonitoring. In the study described in this paper, the diagnostic survey method was used using the HAQ health questionnaire and the analysis of medical records.

Results. In patients after procedures without the use of intraoperative monitoring, postoperative complications were observed more often than in patients with monitoring. Patients after procedures without neuromonitoring more often had hoarseness as a complication after the procedure.

Conclusions. Based on the conducted research, it can be concluded that intraoperative neuromonitoring during thyroid surgery has an impact on the better quality of life of patients after surgery. (JNNN 2023;12(3):112–119)