Evidence map›Paper›PMID 35546031›Full record

ArticleActa bio-medica : Atenei Parmensis2022

Intraoperative Neuromonitoring, Nerves at Risk and Staged Thyroidectomy, our Experience on 377 Consecutive Cases.

Matteo Rossini, Federico Cozzani, Tommaso Loderer, Elena Bonati, Mario Giuffrida, Paolo Del Rio

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Article in Acta bio-medica : Atenei Parmensis, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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1 · What the graph read from it

What it found

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3 · Its place in the literature

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3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Matteo RossiniGeneral Surgery Unit, Parma University Hospital. matteo.rossini86@gmail.com.
Federico CozzaniGeneral Surgery Unit, Parma University Hospital. federico.cozzani@unipr.it.
Tommaso LodererGeneral Surgery Unit, Parma University Hospital. tommasoloderer@gmail.com.
Elena BonatiGeneral Surgery Unit, Parma University Hospital. ebonati86@gmail.com.
Mario Giuffridaa:1:{s:5:"en_US";s:25:"Parma University Hospital";}. mario.giuffrida4@gmail.com.
Paolo Del RioGeneral Surgery Unit, Parma University Hospital. paolo.delrio@unipr.it.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe aim of this study was firstly to report the experience of intermittent intraoperative neuromonitoring (I-IONM) and evaluate the impact of loss of signal (LOS) in staged thyroidectomy management.

methodsWe retrospectively reviewed patients who underwent total thyroidectomy, performed by a single surgeon in two years. All patients have been subjected to I-IONM. In case of intraoperative loss of signal (LOS), planned total thyroidectomy was always aborted. Six-month follow-up was performed. Postoperative dysphonia was evaluated with VHI-10 score in 3 time settings T1, during hospital stay, T2 after 30 days, T3 after 6 months. Dysphonia has been compared to IONM results to evaluate sensitivity and specificity.

results377 patients were included. Incidence of dysphonia was calculated based on the number of nerves at risk (NAR). We evaluated a total of 724 NAR. LOS encountered were 43 cases (5.9% of total NAR), of these 14 were LOS 1 while 29 were LOS 2. 27 patients (3.7% of NAR) presented early post-operative dysphonia with VHI-10 score > 13 (T1), among these 16 had presented LOS at IONM (true positives) while11 had no LOS (false negatives). In T2 and T3 we reported a decrease in true positive cases increasing false positives. Sensitivity at T3 reached 85.7% while specificity and odds ratio were respectively 94.8% and 110.

conclusionsGiven the high sensitivity and specificity, IONM should be considered a useful tool for thyroid surgery and its use should be suggested for patients undergoing planned total thyroidectomy. Its right application may cancel the risk of bilateral paralysis.

Indexed as

DysphoniaThyroidectomyHumansRetrospective StudiesSensitivity and SpecificityThyroid Gland

Identifiers

PMID35546031
PMCPMC9171876

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