Evidence map›Paper›PMID 18806939›Full record

Trial reportSurgical endoscopy2009

Neuromonitoring and video-assisted thyroidectomy: a prospective, randomized case-control evaluation.

Gianlorenzo Dionigi, Luigi Boni, Francesca Rovera, Alessandro Bacuzzi, Renzo Dionigi

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Surgical endoscopy, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06002984 (Effectiveness of Intraoperative Neuromonitoring to Identify and Preserve External Branch of Superior Laryngeal Nerve During Thyroid Surgery), which is not on this map. Cited by 47 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06002984 narecruitingnot on this mapstarted 2023, after this paper: background citation

Effectiveness of Intraoperative Neuromonitoring to Identify and Preserve External Branch of Superior Laryngeal Nerve During Thyroid Surgery

TypeinterventionalSponsorSeoul National University HospitalRan2023 to 2026Enrolled94ConditionsLaryngeal Nerve Injuries, Thyroidectomy, Voice ChangeArmsUsing Neuromonitoring to find EBSLN
3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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  5. Meta-analysis of recurrent laryngeal nerve injury in thyroid surgery with or without intraoperative nerve monitoring.Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale · 2014
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  6. Neuromonitoring in thyroidectomy: a meta-analysis of effectiveness from randomized controlled trials.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2013
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  16. Role of Intraoperative Neuromonitoring to Identify External Branch of Superior Laryngeal Nerve During Thyroidectomy.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Gianlorenzo DionigiDepartment of Surgical Sciences, Endocrine Surgery Research Center, University of Insubria, Varese, Italy. gianlorenzo.dionigi@uninsubria.it
Luigi Boni
Francesca Rovera
Alessandro Bacuzzi
Renzo Dionigi

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis study evaluates the role of intraoperative neuromonitoring (IONM) in video-assisted thyroidectomy (VAT) with emphasis given to the identification of recurrent laryngeal nerve (RLN) and external branch of superior laryngeal nerve (EBSLN).

methodsThe study was based on a prospectively randomized series comprising 72 standard VAT gasless approaches. In the control group (N = 36), the laryngeal nerves were identified by 30 degrees 5-mm endoscope magnification solely. The standard technique of the IONM group (N = 36) consisted of localizing and monitoring EBSLN, both vagus and RLNs, before and after thyroid resection to prove nerve integrity. Surgical outcomes were mean operative time, nerve representation, incision length, and morbidity.

resultsAll procedures were performed successfully. There were no instances of equipment malfunction or interference. No permanent complications occurred in either group. The incidences of temporary RLN injury were 2.7% (1 patient) and 8.3% (3 patients) in the IONM and control group, respectively. The EBSLN was identified better in the IONM group: 83.6% versus 42% (p < 0.05). In the IONM group, a negative electromyography (EMG) response indicated an altered function of RLN and stage thyroidectomy was scheduled.

conclusionsThis is the first VAT series with a standardized IONM technique. The technical feasibility and safety of IONM in selected patients seem acceptable. Neuromonitoring during VAT is effective in providing identification and function of laryngeal nerves. IONM enables surgeons to feel more comfortable with their approach to VAT. A reduction of rates for postoperative complications could not be demonstrated in the present study. Larger series are needed for further evaluation.

Indexed as

Laryngeal Nerve InjuriesMonitoring, IntraoperativeRecurrent Laryngeal Nerve InjuriesAdultAgedCase-Control StudiesFemaleHumansMaleMiddle AgedProspective StudiesThyroid DiseasesThyroidectomyTrauma, Nervous SystemVideo-Assisted Surgery

Identifiers

PMID18806939

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.