Evidence map›Paper›PMID 25210215›Full record

SynthesisActa otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale2014

Meta-analysis of recurrent laryngeal nerve injury in thyroid surgery with or without intraoperative nerve monitoring.

F Rulli, V Ambrogi, G Dionigi, S Amirhassankhani, T C Mineo, F Ottaviani, A Buemi, P DI Stefano, M Mourad

Abstract readMeta-Analysis
PubMed Full text at PMC
In one paragraph

Synthesis in Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 4 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Guideline
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Article
  7. Review
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  14. Minimally-invasive conservative techniques in management of thyroid carcinoma: a narrative review.Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale · 2024
    Review
  15. Review
  16. Review
  17. Intra Operative Recurrent Laryngeal Nerve Monitering During Thyroid Surgery - Is It Worth?Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2023
    Article
  18. An Exposition on Surgical Experiences in Identification, Exposure, and Injuries of Recurrent Laryngeal Nerve (RLN) During Thyroid Operations: Gleanings, Narrative, and the Reflections.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2023
    Article
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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

9 authors.

F RulliDepartment Clinical Sciences and Translational Medicine, Tor Vergata University Hospital, University of Rome Tor Vergata, Italy;
V AmbrogiDepartment Clinical Sciences and Translational Medicine, Tor Vergata University Hospital, University of Rome Tor Vergata, Italy;
G DionigiDepartment of Surgical Sciences and Human Morphology, University of Insubria, Varese, Italy;
S AmirhassankhaniDepartment Clinical Sciences and Translational Medicine, Tor Vergata University Hospital, University of Rome Tor Vergata, Italy;
T C MineoDepartment of Experimental Medicine and Surgery, Tor Vergata University Hospital, University of Rome Tor Vergata, Italy;
F OttavianiDepartment Clinical Sciences and Translational Medicine, Tor Vergata University Hospital, University of Rome Tor Vergata, Italy;
A BuemiDepartment of Surgery, Surgery and Abdominal Transplantation Division, Cliniques Universitaires St. Luc, Université Catholique de Louvain, Brussels, Belgium;
P DI StefanoDepartment of Statistical Medicine, Medtronic®, Italy;
M MouradDepartment of Surgery, Surgery and Abdominal Transplantation Division, Cliniques Universitaires St. Luc, Université Catholique de Louvain, Brussels, Belgium;

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Intraoperative nerve monitoring (IONM) aimed at reducing the injuries of recurrent laryngeal nerve during thyroidectomy is controversial. We conducted a meta-analysis to assess the incidence of nerve injuries with or without IONM. Studies published from January 1994 to February 2012 in English language on humans were identified. Heterogeneity of studies was checked by the Higgins test. Summary estimates of predictive values of injury were made using the Mantel-Haenszel test based on the fixed-effects model. Publication bias was assessed by a funnel plot and Egger's method. Eight articles were selected accounting a total of 5257 nerves at risk. IONM revealed a significant impact in preventing transient injuries (positive predictive value = 5% [95% CI: 2-8], negative = 96% [95% CI: 91-100], relative risk = 0.73 [95% CI: 0.54-0.98], p = 0.035), whereas they failed to demonstrate effect on permanent injuries (positive predictive value = 2% [95% CI: 0.6-3.8], negative 99% [95% CI: 97-100], relative risk = 0.73 [95% CI: 0.44-1.23], p = 0.235). This meta-analysis demonstrated the merit of IONM in preventing transient injury during thyroidectomy. No advantage was found in permanent injuries.

Indexed as

Monitoring, IntraoperativeThyroidectomyHumansIntraoperative ComplicationsRecurrent Laryngeal Nerve InjuriesIntraoperative neurostimulationMeta-analysisRecurrent laryngeal nerveThyroid surgery

Identifiers

PMID25210215
PMCPMC4157532

What OpenQuestion holds

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Registered trials

None linked

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.