Trial reportWorld journal of surgery2012
Randomized controlled trial of visualization versus neuromonitoring of the external branch of the superior laryngeal nerve during thyroidectomy.
Trial report in World journal of surgery, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 65 papers, 6 of them syntheses that pooled 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.
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.
Clinical Validation of NerveTrend vs. Conventional i-IONM Mode of NIM Vital in Prevention of Recurrent Laryngeal Nerve Events During Bilateral Thyroid Surgery.
Effectiveness of Intraoperative Neuromonitoring to Identify and Preserve External Branch of Superior Laryngeal Nerve During Thyroid Surgery
Who cites it
65 citing papers in PubMed, 6 syntheses or guidelines pooled it, 167 citations in OpenAlex.
- 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer.Thyroid : official journal of the American Thyroid Association · 2025Guideline
- The 2024 revised clinical guidelines on the management of thyroid tumors by the Japan Association of Endocrine Surgery.Endocrine journal · 2025Guideline
- Intraoperative neuromonitoring versus visual nerve identification for prevention of recurrent laryngeal nerve injury in adults undergoing thyroid surgery.The Cochrane database of systematic reviews · 2019Pooled it
- Surgical anatomy of the external branch of the superior laryngeal nerve: a systematic review and meta-analysis.Langenbeck's archives of surgery · 2018Pooled it
- 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer.Thyroid : official journal of the American Thyroid Association · 2016Guideline
- 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 · 2013Pooled it
- Experience over tools: does the use of magnifying loupes reduce the incidence of transient postoperative hypocalcemia after total thyroidectomy with central neck dissection? - a single-centre prospective randomized study.Frontiers in endocrinology · 2026Trial
- Visual identification and neuromonitoring vs. no sighting the external branch of the superior laryngeal nerve in thyroid surgery: a randomized clinical trial.Updates in surgery · 2022Trial
- Efficacy of ketamine for postoperative pain following robotic thyroidectomy: A prospective randomised study.The Journal of international medical research · 2018Trial
- Contribution of intraoperative neural monitoring to preservation of the external branch of the superior laryngeal nerve: a randomized prospective clinical trial.Langenbeck's archives of surgery · 2017Trial
- Normative intra-operative electrophysiologic waveform analysis of superior laryngeal nerve external branch and recurrent laryngeal nerve in patients undergoing thyroid surgery.World journal of surgery · 2013Trial
- Intraoperative neuromonitoring for preservation of the external branch of the superior laryngeal nerve in transoral endoscopic thyroidectomy: initial experience from Vietnam.Frontiers in surgery · 2026Article
- Intraoperative Nerve Monitoring Parameters and Risk of Recurrent Laryngeal Nerve Injury in Thyroidectomy: A Systematic Review and Meta-Analysis.Biomedicines · 2025Review
- Article
- Article
- 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 · 2025Article
- Thyroid cartilage needle vs. endotracheal tube electrodes in EBSLN monitoring during thyroidectomy.Updates in surgery · 2024Article
- Paradigms of intraoperative neuromonitoring in paediatric thyroid surgery.Frontiers in endocrinology · 2024Review
- Revisiting Loré's retrograde thyroidectomy from the perspective of preserving the external branch of the superior laryngeal nerve.Gland surgery · 2023Article
- Utility of video-assisted method for identifying and preserving the external branch of the superior laryngeal nerve during thyroidectomy.Frontiers in surgery · 2023Article
5 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInjury to the external branch of the superior laryngeal nerve (EBSLN) during thyroidectomy results in a lowered fundamental frequency of the voice and deteriorated voice performance in producing high-frequency sounds. It remains unclear if the use of intraoperative nerve monitoring (IONM) can improve the clinical outcome of thyroidectomy in terms of preserved individual voice performance. This study was designed to test that hypothesis.
methodsA total of 210 consenting female patients planned for total thyroidectomy were randomly assigned to two groups equal in size (n = 105): visual inspection of the EBSLN and RLN vs. this plus additional EBSLN and RLN monitoring. The primary outcome was the identification rate of the EBSLN. The secondary outcomes included: anatomical variability of the EBSLN according to the Cernea classification and changes in postoperative voice performance. Voice assessment included pre- and postoperative videostrobolaryngoscopy and an analysis of maximum phonation time (MPT), voice level (VL), fundamental frequency (Fo), and voice quality rating on the GRBAS scale.
resultsThe following differences were found for operations without vs. with IONM: identification rate of the EBSLN was 34.3 % vs. 83.8 % (p < 0.001), whereas a 10 % or higher decrease in phonation parameters was found in 10 % vs. 2 % patients for MPT (p = 0.018), 13 % vs. 2 % for VL (p = 0.003), and 9 % vs. 1 % for Fo (p = 0.03), a change in the GRBAS scale > 4 points in 7 % vs. 1 % (p = 0.03), and temporary RLN injury was found in 2 % vs. 1 % (p = 0.56), respectively.
conclusionsThe use of IONM significantly improved the identification rate of the EBSLN during thyroidectomy, as well as reduced the risk of early phonation changes after thyroidectomy.
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What OpenQuestion holds
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.