ArticleAnnals of the Royal College of Surgeons of England2019
Intraoperative nerve monitoring during thyroidectomy: evaluation of signal loss, prognostic value and surgical strategy.
Article in Annals of the Royal College of Surgeons of England, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prevalence and determinants of recurrent laryngeal nerve injury after thyroidectomy: a Systematic Review and meta-analysis.Frontiers in endocrinology · 2026Pooled it
- Comparison of stimulating dissector and intermittent stimulating probe for the identification of recurrent laryngeal nerve in reoperative setting.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 · 2022Trial
- Effect of Electromyography Findings of Traction-Related Signal Loss on Prognosis During Neuromonitored Thyroidectomy.Head & neck · 2026Article
- Symptom clusters and quality of life among patients with thyroid cancer during early survivorship: a national multicenter cross-sectional study.The oncologist · 2026Article
- Surgical training program of parathyroidectomy for residents in a national center: a cohort of 122 cases.Surgery in practice and science · 2026Article
- A Study of Time to Recovery Following Loss of Neuromonitoring Signal of the Recurrent Laryngeal Nerve in Thyroid Surgery.World journal of surgery · 2026Observational
- Partial intraoperative signal recovery is associated with normal postoperative vocal cord motility in patients with intraoperative loss of signal.Updates in surgery · 2025Article
- Intraoperative Nerve Monitoring Parameters and Risk of Recurrent Laryngeal Nerve Injury in Thyroidectomy: A Systematic Review and Meta-Analysis.Biomedicines · 2025Review
- Approach to signal loss in intraoperative nerve monitoring in thyroid surgery questionnaire: a Turkish surgical perspective.Frontiers in endocrinology · 2025Article
- Intraoperative Neuromonitoring Does Not Reduce the Risk of Temporary and Definitive Recurrent Laryngeal Nerve Damage during Thyroid Surgery: A Systematic Review and Meta-Analysis of Endoscopic Findings from 73,325 Nerves at Risk.Journal of personalized medicine · 2023Review
- A Prospective Study of Electromyographic Amplitude Changes During Intraoperative Neural Monitoring for Open Thyroidectomy.World journal of surgery · 2023Article
- Transoral and submental thyroidectomy using intraoperative nerve stimulation and indocyanin green fluorescence imaging.BMJ case reports · 2021Article
- A new anesthesia scheme for parathyroidectomy under neuromonitoring: a retrospective cohort study.Gland surgery · 2021Article
- Anatomical, Functional, and Dynamic Evidences Obtained by Intraoperative Neuromonitoring Improving the Standards of Thyroidectomy.Sisli Etfal Hastanesi tip bulteni · 2021Review
- Role of intraoperative neuromonitoring of recurrent laryngeal nerve in thyroid and parathyroid surgery.The Journal of international medical research · 2020Article
- Killian-Jamieson diverticulum safely resected using a manual intraoperative neural monitoring system: a case report.Surgical case reports · 2020Article
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7 authors.
Funding
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Abstract
introductionIntraoperative neural monitoring of the recurrent laryngeal nerve has been widely used to avoid nerve injury during thyroidectomy. We discuss the results of the change in surgical strategy after unilateral signal loss surgeries using intermittent intraoperative neural monitoring in a high-volume referral centre. MATERIALS AND
methodsDetails of consecutive patients who underwent thyroidectomy with intermittent intraoperative neural monitoring between January 2014 and December 2017 were prospectively recorded and retrospectively reviewed. Loss of signal was defined as recurrent laryngeal nerve amplitude level lower than 100 μV during surgery. The rate of loss of signal and change in surgical strategy during the operation were evaluated.
resultsLoss of signal was detected in 25 (5.4%) of 456 patients for whom intermittent intraoperative neural monitoring was performed. Four patients had anatomic nerve disruption and surgery was completed by an experienced endocrine surgeon making use of intraoperative neural monitoring with continuous vagal stimulation. Staged thyroidectomy was performed on 16 patients with unilateral loss of signal in whom the nerves were intact visually. Postoperative vocal cord paralysis was encountered in 18 of 21 (85.7%) patients with loss of signal, and 16 of 18 (88.8%) were improved during the follow-up period. Patients' voices were subjectively normal to the surgeon postoperatively in 9 of 21 (42.8%) patients who were found to have loss of signal with intact nerves.
conclusionsIntraoperative neural monitoring can be used safely in thyroid surgery to avoid recurrent laryngeal nerve injury. It enables the surgeon to diagnose recurrent laryngeal nerve injury intraoperatively to estimate the postoperative nerve function and to modify the surgical strategy to avoid bilateral vocal cord paralysis.
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