SynthesisWorld journal of surgery2016
Intraoperative Neuromonitoring in Thyroid Surgery: A Systematic Review.
Synthesis in World journal of surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 5 of them syntheses that pooled it.
What it found
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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.
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Who cites it
35 citing papers in PubMed, 5 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- The 2024 revised clinical guidelines on the management of thyroid tumors by the Japan Association of Endocrine Surgery.Endocrine journal · 2025Guideline
- Care and Management of Voice Change in Thyroid Surgery: Korean Society of Laryngology, Phoniatrics and Logopedics Clinical Practice Guideline.Clinical and experimental otorhinolaryngology · 2022Guideline
- The surgical treatment of unilateral vocal cord paralysis (UVCP): qualitative review analysis and meta-analysis study.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 · 2019Pooled it
- 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
- The current state of intermittent intraoperative neural monitoring for prevention of recurrent laryngeal nerve injury during thyroidectomy: a PRISMA-compliant systematic review of overlapping meta-analyses.Langenbeck's archives of surgery · 2017Pooled it
- Recovery Takes Time: Loss of Signal Predicts Delayed Recovery of Vocal Cord Function After Thyroidectomy.Journal of clinical medicine · 2026Article
- Effect of Intraoperative Nerve Monitorization on Predicting Vocal Cord Paralysis in Thyroid Surgery.International archives of otorhinolaryngology · 2026Article
- Safety and Efficacy of Intraoperative Neuromonitoring: An Umbrella Review.Health science reports · 2025Review
- Intraoperative nerve monitoring in thyroid and parathyroid surgery: a decade of Italian practice.Updates in surgery · 2025Article
- Safety and Outcomes of Thyroid Surgery: A High-Volume Center Case Series and the Role of Intraoperative Neuromonitoring in Preventing Complications.Journal of clinical medicine · 2025Article
- Proposal of integrated clinical pathway in the management of perioperative recurrent laryngeal nerve injury post thyroid and parathyroid surgery.Scientific reports · 2025Article
- Thyroidectomy and Its Complications: A Comprehensive Analysis.Biomedicines · 2025Article
- Intraoperative neuromonitoring during thyroidectomy does not decrease vocal cord palsy risk, but the cumulative experience of the surgeon may.Surgery today · 2024Article
- Recent Advances in the Surgical Management of Thyroid Cancer.Current oncology (Toronto, Ont.) · 2023Review
- Proving the Superiority of Intraoperative Recurrent Laryngeal Nerve Monitoring over Visualization Alone during Thyroidectomy.Biomedicines · 2023Article
- The global status and hotspots of research in the field of trans-oral endoscopic thyroidectomy (TOET) from 2008 to 2022.Frontiers in surgery · 2023Article
- Visualization of the recurrent laryngeal nerve alone versus intraoperative nerve monitoring in primary thyroidectomy: a framework approach to a missing typology.Frontiers in surgery · 2023Review
- Intraoperative Neuromonitoring for Thyroid Surgery in Children and Adolescents: A Single Center Experience.Children (Basel, Switzerland) · 2022Article
- Seeing Is Not Believing: Intraoperative Nerve Monitoring (IONM) in the Thyroid Surgery.Indian journal of surgical oncology · 2022Review
- Revision Thyroid Surgery.Indian journal of surgical oncology · 2022Review
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This study aimed to assess the efficacy of intraoperative neurophysiologic monitoring (IONM) in preventing recurrent laryngeal nerve palsy (RLNP) during thyroid surgery. When IONM results in false positives, it seeks to evaluate contributing factors. A systematic review was conducted gauging the predictive power of neuromonitoring in determining RLN function intraoperatively, its reductions of temporary and permanent RLNP rates, and surgeons' response to the technology. MEDLINE, EMBASE, and PubMed were searched for RLN monitoring in thyroid surgery following a set of inclusion/exclusion criteria. Seventeen studies comparing thyroid surgery with and without IONM were reviewed, including 30,926 patients. Selected studies were pooled to gage the predictive power. Mean specificity of IONM in identifying functional nerves was 90.24 % among 7366 nerves at risk (NAR). However, mean positive predictive power (PPP) was low, and both specificity and PPP varied substantially when stratified by risk levels. Among the pooled studies focusing on IONM efficacy-there were 44,575 NAR, of which (57.98 %) were operated on with IONM and 18,732 (42.02 %) without (control). The rates of overall RLNP per NAR were 3.18 and 3.83 % for the IONM group and control, respectively. There is no statistically significant difference between IONM and control, a conclusion supported by qualitative analysis from many individual studies. IONM is not recommended as the standard of care for thyroidectomies. Low PPP of IONM and complications associated with IONM-assisted thyroidectomies may be attributed to either the absence of a standardized negative-signal cutoff value or injury from intubation.
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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.