Intermittent Neuromonitoring of the Recurrent Laryngeal and Vagus Nerves: the Ins and Outs

AbstractPurpose of ReviewIntermittent intraoperative nerve monitoring has remained a controversial topic in endocrine neck surgery as several studies have produced nonuniform results. Although continuous intraoperative nerve monitoring is a newer technology, intermittent monitoring is still a useful adjunct in safe thyroid surgery when used correctly. This work summarizes the benefits, limitations, setup, and troubleshooting techniques for this technology.Recent FindingsThere are randomized controlled trials and meta-analyses supporting the use of intermittent neuromonitoring in thyroid surgery, but it has not been consistently demonstrated to improve outcomes compared to the gold standard of nerve visualization alone.SummaryAlthough intermittent neuromonitoring has not been consistently shown to reduce rates of vocal cord paralysis, it is particularly useful in intraoperative neural identification, nerve dissection, and neural prognostication to prevent bilateral vocal cord paralysis. Future research may further compare outcomes between use of intermittent and continuous neuromonitoring in thyroid surgery.
Source: Current Otorhinolaryngology Reports - Category: ENT & OMF Source Type: research