Thyroid surgery is a technically specific surgery involving highly detailed anatomy. Jane Lee, Sheila Fraser, Anthony Glover, Stan Sidhu, Prospective evaluation of the utility of routine neuromonitoring for an established thyroid surgical practice, ANZ Journal of Surgery, 10.1111/ans.13606, 87, 10, (E138-E142), (2016). 1 The IONM system consists of recording and stimulation sides. Neuromonitoring Für mehr Sicherheit im klinischen Alltag und für mehr Lebensqualität der Patienten. monitoring Review Article Medico-Legal Issues of Intraoperative ... In our study, the use of IONM did not reduce the time of thyroid surgery and did increase the cost. While IONM may, in special clinical circumstances such as revision and malignant thyroid surgery, increase the value of the operation, its use for every thyroid surgery does not appear to be cost effective or valuable to the patient. Dionigi et al (2013) stated that IONM contributes in several ways to RLN protection. Recurrent laryngeal nerve (RLN) injury is the most feared complication in thyroid surgery, resulting in a worse patients’ quality of life, and is the most common cause of medical claim. Notwithstanding these advantages, surgeons must be aware that the current, intermittent mode of IONM (I-IONM) has relevant limitations. Neuromonitoring 2016 Mar. Electromyographic Some authors believe that the method does not bring any additional reduction in the paralysis rate of the laryngeal nerves. Basic principles of IONM. We have analysed 14 early postoperati … during thyroid surgery is a factor that may affect intraoperative neuromonitoring data and should be taken into account by the surgeon during interpretation. The nonuse category was a benefit of neuromonitoring, thyroid surgeons must use composed of those who have never used neuromonitoring other factors in the decision of whether to employ neuro- (49.1%) and those who have used neuromonitoring in the monitoring during thyroid surgery. Weltweit nutzen Spezialisten die Medizintechnik von inomed. Intraoperative Neuromonitoring Products - NIM TriVantage ... Chirurgie Générale, Endocrinienne et Métabolique - Hôpital ... Surgery Electrophysiological neuromonitoring of the laryngeal ... The Journal of Thoracic and Cardiovascular Surgery presents original, peer-reviewed articles on diseases of the heart, great vessels, lungs and thorax with emphasis on surgical interventions. Neuromonitoring is explicitly recommended for redo-operation in thyroid surgery by the German Society for General and Visceral Surgery – German Association of Endocrine Surgeons.* Therefore, documenting the monitoring process and implementing it as rapidly and intuitively as possible are of critical importance in thyroid surgery. Neuromonitoring de Danschutter SJ , Schreinemakers JM , Smit LH , van der Laan L , Nuytinck HK J Invest Surg , 28(2):86-94, 10 Nov 2014 Transcutaneous Recording During Intraoperative Neuromonitoring in Thyroid Surgery. comparing thyroid surgery with and without IONM. Intraoperative neuromonitoring is a promising tool for nerve identification and protection in extended thyroid surgeries, reoperations, retrosternal goiters, advanced thyroid cancer cases, and cases of anatomical variations. Malik R, Linos D. Intraoperative Neuromonitoring in Thyroid Surgery: A Systematic Review. In the meta-analysis of Higgins , intraoperative neuromonitoring and identification alone did not demonstrate a statistically significant difference in rates of total, transient, or persistent true vocal fold palsy with adequately-powered sample sizes for all thyroid surgeries, primary surgery, benign disease, and low-risk groups. 2002 May;127(5):393-4. doi: 10.1055/s-2002-31985. Objective. Intraoperative Neuromonitoring for Thyroid Surgery: The Proven Benefits and Limitations Choi SY1 1, Son YI1. The use of neuromonitoring in thyroid surgery is controversial. Chiang FY, et al. Diseases of the thyroid or the rectum >> affect millions of patients worldwide; the additional risk of neurological incidents can be largely avoided by the use of intraoperative neuromonitoring. Introduction. Neuromonitoring of recurrent and vagus nerves during thyroid surgery has become another useful tool, to anatomically locate the recurrent nerve. * Therefore, documenting the monitoring process and implementing it as rapidly and intuitively as possible are of critical importance in thyroid surgery. 2 Evoked Potential Studies - Medical Clinical Policy Neuromonitoring helped to identify the nerve, in particular in difficult Intraoperative Neuromonitoring (IONM) >> is explicitly recommended by the German Society for General and Visceral surgery* for redo-operations in thyroid surgery. The exact nerve monitored depends on the nerve at risk during the surgical procedure. Introduction. Even experienced surgeons find it difficult to visually identify the recurrent laryngeal nerve (RLN) or vagus nerve during thyroid surgery and other neck dissections. Neuromonitoring in thyroid surgery: attitudes, usage patterns, and predictors of use among endocrine surgeons World J Surg. Thyroid surgery with intraoperative nerve monitoring and continuous vagus stimulation by the APS probe in its procedural steps is a reproduction of its conventional counterpart apart from the supplementary steps of APS probe positioning/removal and RLN function control by initial and final vagus stimulation. Lu et al. Patients with previous nerve palsy as documented by laryngoscopy was excluded. 1. Methods: Data from 493 patients (839 nerves at risk [NAR]) who underwent thyroid surgery between July 2014 and May 2016 were retrospectively evaluated. Why Use NIM TriVantage™ EMG Tubes? nerve during thyroid surgery and other neck dissections. Thyroid surgery can be done with neuromonitoring. Four key terms and/or phrases (neuromonitoring AND thyroid AND neck surgery, intraoperative neuromonitoring, intraoperative electrophysiological monitoring, IONM) were entered separately into the search engines Google.com, Yahoo.com and Bing.com.The first 50 results obtained for each search procedure were evaluated. The EMG electrode is an effective recurrent laryngeal nerve integrity monitor during Thyroid surgery.¹ . The use of nondepolarizing neuromuscular blocking agents (NMBAs) may affect intraoperative neuromonitoring (IONM) during anesthesia used during thyroid and parathyroid surgery. Maintaining a balance between the risk of awakening during surgery and excessively deep anaesthesia in fast track surgery is an important task for the anaesthesiologist. Thyroid surgery can be done with neuromonitoring. Keywords endocrine surgery , robotic surgery , evidence-based medicine/surgery This is especially the case when performing a partial removal of the thyroid and more particularly with the complete removal of … As the official journal of two of the largest American associations in its specialty, this leading monthly enjoys outstanding editorial leadership and maintains rigorous selection standards. Evidence is needed to establish the proper indications for its application. Continuous intraoperative neuromonitoring (cIONM) in thyroid surgery; Target group. Nach den Erstbeschreibern der heute am häufigsten angewendeten Operationstechnik wird sie im vollen Wortlaut auch als „beidseitige subtotale … Malik R, Linos D. Intraoperative Neuromonitoring in Thyroid Surgery: A Systematic Review. As a consequence, intraoperative neuromonitoring (IONM) has become an indispensable aid in modern thyroid surgery over the last 15 years. Dionigi et al (2013) stated that IONM contributes in several ways to RLN protection. Introduction. 1 The number of patients with TC has been increasing due to the Studies show that the rate of RLN injury is under-estimated 1 and intraoperative nerve monitoring of the RLN is recommended as a risk-minimizing tool. C2 NerveMonitor Neuromonitoring is explicitly recommended for redo-operation in thyroid surgery by the German Society for General and Visceral Surgery – German Association of Endocrine Surgeons. However, one of the main complications of thyroid surgery is recurrent laryngeal nerve (RLN) palsy, which impairs the quality of patients' lives largely with hoarseness and incidental aspiration. By expanding its range of applications, the C2 is a reliable partner in ENT surgery. Other researchers defend its use only in selected cases and in very specific situations. World J Surg 2016;40:2051-8. 33: 417-25. Intraoperative neuromonitoring in thyroid surgery explicitly recommended by guidelines. Visualization of RLN before proceeding with dissection of the gland is considered the gold standard. Anatomical variations of recurrent laryngeal nerve during thyroid surgery; how to identify and handle the variations with intraoperative neuromonitoring. Pisanu A, Porceddu G, Podda M, et al. Finally, some much respected surgeons advocate the routine use of neuromonitoring in all thyroidectomies. [Intraoperative neuromonitoring in thyroid surgery and surgery of the parathyroid gland] Zentralbl Chir. This makes the C2 NerveMonitor a true specialist for operations in the field of thyroid surgery. Methods The use of sugammadex was evaluated in a prospective clinical study during thyroid surgery. Intraoperative neuromonitoring in thyroid surgery: a point prevalence survey on utilization, management, and documentation in Italy. This study aimed to investigate the influence of neck extension on electromyographic (EMG) endotracheal tube displacement and to determine the necessity of routinely checking the final electrode position after the patient had been fully positioned. It is used in patients with cognitive dysfunction involving either a general decline of overall brain function or a localized or lateralized deficit. 2002 May;127(5):393-4. doi: 10.1055/s-2002-31985. The influence of muscle relaxation on the intra-operative neuromonitoring of the recurrent laryngeal nerve during thyroid surgery is unclear. Some recent studies have shown that intraoperative neuromonitoring (IONM) can aid the recurrent laryngeal nerve (RLN) identification during thyroid surgery. Transcutaneous Recording During Intraoperative Neuromonitoring in Thyroid Surgery Thyroid. Electrophysiological neuromonitoring of the laryngeal nerves in thyroid and parathyroid surgery: A review Ahmed Deniwar , Parisha Bhatia , and Emad Kandil Ahmed Deniwar, Parisha Bhatia, Emad Kandil, Division of Endocrine and Oncologic Surgery, Department of Surgery, Tulane University School of Medicine, New Orleans, LA 70112, United States In the last decade, intraoperative neuromonitoring (IONM) of RLN has progressively … Application of IONM in thyroid surgeries was initially proposed by Shedd in 1966 and by Flisberg in 1970. Key Words: Continuous intraoperative neuromonitoring, recurrent laryngeal nerve injury, thyroid cancer surgery, surgical education. Pisanu A, Porceddu G, Podda M, et al. Systematic review with meta-analysis of studies comparing intraoperative neuromonitoring of recurrent laryngeal nerves versus visualization alone during thyroidectomy. We performed a literature search using electronic search engines PubMed and Ovid, and the Cochrane Library database to identify all clinical trials published between January 1994 and February 2012 that included the words "neuromonitoring AND thyroid AND neck surgery, intraoperative neuromonitoring, intraoperative electrophysiological … Wu CW, Dionigi G, Sun H, et al. Attitudes about neuromonitoring, usage patterns, and predictors of use have not been formally studied. Search in PubMed Search in NLM Catalog Add to Search . As thyroid surgery evolves, nowadays, the use of intraoperative neuromonitoring (IONM) has become widely accepted as a valuable adjunct to the gold standard method of … The intraoperative neuromonitoring (IONM) for the prevention of RLN injury is a useful method because it can identify the location and status of RLN and predict postoperative vocal cord function easily. Che-Wei Wu, Feng-Yu Chiang, Gregory W. Randolph, Gianlorenzo Dionigi, Hoon Yub Kim, Yi-Chu Lin, Tzu-Yen Huang, Chiao-I Lin, Pao-Chu Hun, Dipti Kamani, Pi-Ying Chang, and ; I … Kaohsiung J Med Sci. Dragonfly intraoperative neuromonitoring EMG electrodes are available in multiple sizes and three designs. The recurrent laryngeal nerve (RLN) is the most important structure at risk during thyroidectomies. Notwithstanding these advantages, surgeons must be aware that the current, intermittent mode of IONM (I-IONM) has relevant limitations. Intraoperative Neuromonitoring (IONM) Intraoperative neuromonitoring refers to the techniques used to monitor nerve function during a surgery. Background: The use of neuromonitoring in thyroid surgery is controversial. Methods: IONM clinical usage rationale, efficiency, and safety profile are discussed in this overview in thyroid and parathyroid surgery. Studies show that the rate of RLN injury is under-estimated 1 and intraoperative nerve monitoring of the RLN is recommended as a risk-minimizing tool. Intraoperative neuromonitoring (IONM) has been first proposed as an adjunct to standard visual identification of the recurrent laryngeal nerve (RLN) during thyroid surgery in 1966 by Shedd. Summary Background Data: Neuromonitoring has been advocated to reduce the risk of vocal cord palsy and to predict postoperative vocal cord function. All signals are displayed acoustically and visually via the C2 Xplore (IOM system for thyroid surgery >>). 2010;19:25-37. Authors Che-Wei Wu 1 … The thyroid gland is a midline structure located in the anterior neck. The technique of intraoperative neuromonitoring in thyroid surgery. Introduction. Over the last 20 years, there has been a clear trend in thyroid and parathyroid surgery in the use of intraoperative neural monitoring (IONM) to support identification and dissection of the recurrent laryngeal nerve (RLN), facilitate assessment of vocal cord (VC) function and voice outcomes, neurophysiological research, surgical education and training, and medico … In surgeries using neuromonitoring, the system must be in harmony with anesthesia. The Using pooled data from those studies, authors found no statistically significant difference in recurrent laryngea l nerve palsy (RLNP) between those who had undergone thyroid surgery with or without IONM. Systematic review with meta-analysis of studies comparing intraoperative neuromonitoring of recurrent laryngeal nerves versus visualization alone during thyroidectomy. Neuromonitoring in thyroid surgery. Specialist backs doing it in the clinic using ultrasound (SRI Magazine, 2016) Oral cancer surgery hopes to improve outcomes (May 27, 2011) Throat cancer cases increasing (Toronto Star, March 31, 2011) Is Michael Douglas' throat cancer cured? Attitudes about neuromonitoring, usage patterns, and predictors of use have not been formally studied. Functionality. comparing thyroid surgery with and without IONM. It is especially suitable to identify the recurrent nerve and to monitor its function during thyroid operation. World J Surg 2016;40:2051-8. IONM legal issues No. Neuromonitoring as the standard of care . PINION Neuromonitoring in thyroid surgery Claudio R. Cernea, Lenine G. Branda˜o, and Jose´ Branda˜o Purpose of review Laryngeal nerve injuries are among the most important complications of thyroidectomy. Neuromonitoring in thyroid surgery: Attitudes, usage patterns, and predictors of use among endocrine surgeons Cord Sturgeon * , Treena Sturgeon, Peter Angelos * … We hypothesized that attitudes would predict usage patterns and that the predominant strategy among endocrine surgeons would be no neuromonitoring during thyroid surgery. Doctors who already use IONM and who want to deepen their knowledge; Doctors who are responsible for IONM or who want to establish the use of IONM in their clinic; In this course you will learn. Multiple sizes, universal design. Surgery 2008;143:743-9. Recurrent laryngeal nerve (RLN) injury during thyroid surgery is the most common etiology of vocal fold motion (VFM) impairment and morbidity after this procedure and a leading cause of medico-legal litigation after thyroid surgery ().To avoid RLN injury during thyroid surgery, adjunct use of intraoperative neuromonitoring (IONM) has gained … The greatest risk of injury to the recurrent laryngeal nerve is produced in: substernal goitre, hyperthyroidism, reinterventions and malignant tumours.14. intraoperative neuromonitoring (cIONM) in 20 patients who underwent thyroid surgery for different diagnoses. World J Surg. … 11. Levels of Evidence: 3b INTRODUCTION According to the National Cancer Registry, 19,000 peo-ple in Japan are suffering from thyroid cancer (TC). Neuromonitoring in otology and head and neck surgery. surgical staplers, linear, circulating staplers/cutters manufactured by ethicon endo surgery, inc recall recs 01/01/2009 - 12/31/2013 2015-8910 Williams Kastner & Gibbs, LLC The mechanism of recurrent laryngeal nerve injury during thyroid surgery--the application of intraoperative neuromonitoring. The C2 Xplore is known as a smart specialist for various surgical applications, and is the result of inomed‘s several years of experience and intensive research in the field of intraoperative neuromonitoring. 15. Introduction. For thyroid and parathyroid procedures, the laryngeal nerves are at risk of injury (the recurrent laryngeal nerve and the… The gold standard for protecting the nerve is identifying it through careful dissection before proceeding with the removal of the thyroid gland. Methods The use of sugammadex was evaluated in a … RLN injury is a rare complication of thyroid surgery (0.4-12% of cases) and usually results from transection, traction, suture entrapment or thermal injury. Unsere Klinik für Endokrine Chirurgie wurde Anfang 2012 als “Referenzzentrum für Schilddrüsen- und Neben­schild­drüsen­chirurgie” von der Deutschen Gesell­schaft für Allgemein- und Viszeralchirurgie und der Chirurg­ischen Arbeitsgemeinschaft für Endokrinologie zertifiziert. We provide the appropriate auxiliary aids and services, including qualified sign language interpreters, TTYs and … Keywords endocrine surgery, robotic surgery, evidence-based medicine/surgery IONM, the gold standard for identifying and managing at-risk nerves, plays an important role in protecting the recurrent laryngeal nerve (RLN) during thyroid surgery. undesirable complication during thyroid surgery because it can lead to hoarseness, dysphonia, dysphagia, pulmonary aspiration, and life-threatening airway obstruction (1,2). Notwithstanding these advantages, surgeons must be aware that the current, intermittent mode of IONM (I-IONM) has relevant limitations. Epub 2018 Aug 24. The use of nondepolarizing neuromuscular blocking agents (NMBAs) may affect intraoperative neuromonitoring (IONM) during anesthesia used during thyroid and parathyroid surgery. Intraoperative neuromonitoring during thyroid surgery is a reliable tool for early recurrent laryngeal nerve localization and identification, certainly in complicated thyroid operations. (CTV News, January 11, 2011) Related Links: The recording side obtains electromyographic (EMG) signals evoked from intrinsic laryngeal muscles. View PubMed CLIN EXP OTORHINOLARYNGOL 2019 10.21053/ceo.2019.00444 Early Injection Laryngoplasty Witha Long-Lasting Material in Patients With Potentially Recoverable Unilateral Vocal Fold Paralysis Choi 1 , N; Jin, H; Kim, HJ; Son, YI Many surgical innovations have been developed in our department such as endoscopic and mini invasive techniques, radio-guided surgery, Introperative hormone assay, nerve neuromonitoring… More recently, we were the first University Hospital in France to develop radiofrequency ablation for thyroid nodules. Using pooled data from those studies, authors found no statistically significant difference in recurrent laryngea l nerve palsy (RLNP) between those who had undergone thyroid surgery with or without IONM. Reduction in neurological incidents during surgery on the thyroid. Key Words: Continuous intraoperative neuromonitoring, recurrent laryngeal nerve injury, thyroid cancer surgery, surgical education. 2018 Nov;28(11):1500-1507. doi: 10.1089/thy.2017.0679. 1 Experience has shown that IONM allows the laryngeal nerves, both inferior and superior, to be reliably identified during neck surgery. A systematic review was conducted gauging the pre … Stopa M. Prognostic value of intraoperative neural monitoring of the recurrent laryngeal nerve in thyroid surgery. This website uses cookies to help provide you with the best possible online experience. Intraoperative neuromonitoring. 2 also reported that the correlated twitch of neuromuscular transmission showed around 73% of recovery at 30 min after administration of 1 ED 95 of rocuronium (0.3 mg/kg) during intraoperative neuromonitoring of RLN in thyroid surgery, and high EMG signals were obtained in all patients at an early stage of surgery . BACKGROUND: Employment of intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) is not unusual nowadays. This study aimed to assess the efficacy of intraoperative neurophysiologic monitoring (IONM) in preventing recurrent laryngeal nerve palsy (RLNP) during thyroid surgery. to patients’ greater confidence to the surgery. Intraoperative neuromonitoring (IONM) is widely used in thyroid surgery. Another systematic review (Yang 2017) reported a We evaluated the ability of neuromonitoring to predict postoperative outcome in patients undergoing thyroid surgery for different indications. Thyroid surgery is a technically specific surgery involving highly detailed anatomy. The recurrent laryngeal nerve (RLN) is the most important structure at risk during thyroidectomies. The gold standard for protecting the nerve is identifying it through careful dissection before proceeding with the removal of the thyroid gland. When there is a decrease in the signal received from the muscles, the neuromonitoring device informs the surgery by giving a warning about the sensitive area. Intraoperative neuromonitoring (IONM) is increasingly being used routinely in thyroid surgery, as it has been shown to prevent RLN injury by facilitating identification The authors noted that the role of neuromonitoring during parathyroid and thyroid surgery is still controversial. Kartush J, Bouchard KR. The transligamental intraoperative neuromonitoring of the recurrent nerve is established in many surgical clinics as an useful and reliable technique. The authors noted that the role of neuromonitoring during parathyroid and thyroid surgery is still controversial. In order to prevent RLN injury during thyroid surgery, intraoperative neuromonitoring has become the gold standard to supplement direct visualization of the nerve. Neuromonitoring in thyroid surgery e195 electrodes. [1][2] Stimulator-attached dissecting instruments are useful for intraoperative nerve monitoring during of neuromonitoring for thyroid surgery both in Asia and across the globe, the authors conducted the current study to investigate the outcomes of thyroidectomies in a tertiary institution in Singapore (Khoo Teck Puat Hospital) with the use of IONM and without (i.e. Intraoperative neuromonitoring (IONM) has gained wide acceptance as an adjunct method for nerve preservation in thyroid surgery. The use of intraoperative neuromonitoring (IONM) as a supplement to enhance surgical identification in thyroid and parathyroid operation appeared to have collected momentum with operators. Google Scholar . Intraoperative neuromonitoring is a promising tool for nerve identification and protection in extended thyroid surgeries, reoperations, retrosternal goiters, advanced thyroid cancer cases, and cases of anatomical variations. Attention should be paid not to abandon the conventional techniques for identifying the laryngeal nerve, as IONM may not always be available. When IONM results in false positives, it seeks to evaluate contributing factors. Safety of Continuous Intraoperative Neuromonitoring (C-IONM) in Thyroid Surgery Alessandro Bacuzzi et al. Intraoperative neuromonitoring (IONM) during thyroid surgery has gained widespread acceptance as an adjunct to the gold standard of visually identifying the RLN, detecting anatomic variations in the RLN, and elucidating the mechanisms underlying RLN injury. Objectives: This study aimed to analyze the effects of intraoperative neuromonitoring (IONM) on the prevalence of vocal cord palsy (VCP) in thyroid surgery. It is very important to identify recurrent laryngeal nerve (RLN) and prevent RLN injury during thyroid surgery. 9 Spine Technology and News Highlights August 2018 SpineUniverse highlights a blend of 9 news briefs covering spine industry corporate news, clinical research, 3D-printing advances and devices, and technical updates from August 2018. Studies show that the rate of RLN injury is under-estimated 1 and intraoperative nerve monitoring of the RLN is recommended as a risk-minimizing tool. 2 Authors stated that IONM … 1 The number of patients with TC has been increasing due to the An official publication of The American Association for Thoracic Surgery and The Western Thoracic Surgical Association, the Journal focuses on techniques and … Cernea CR(1), Brandão LG, Brandão J. The groundbreaking surgery took place at The Johns Hopkins Hospital on June 8, 2020. (2012). Alesina PF, Rolfs T, Hommeltenberg S, et al. Methods: Data from 493 patients (839 nerves at risk [NAR]) who underwent thyroid surgery We hypothesized that attitudes would predict usage patterns and that the predominant strategy among endocrine surgeons would be no neuromonitoring during thyroid surgery. Why Use NIM TriVantage™ EMG Tubes? Methods In a prospective study involving 200 patients undergoing elective thyroid surgery, the influence of muscle relaxation on neuromonitoring of the recurrent laryngeal nerve was investigated. Another systematic review (Yang 2017) reported a Intraoperative neuromonitoring involves the transmission of minute current pulses to the nerve with special stimulation probes. The surgery was performed by a single surgeon at an established teaching hospital and included benign and malignant cases. 2010; 26(11):575-583. We would like to show you a description here but the site won’t allow us. The RLN is located on either side of the thyroid gland and serves several important functions, including control of vocal cord movement. cerneamd@uol.com.br PURPOSE OF REVIEW: Laryngeal nerve injuries are among the most important complications of thyroidectomy. A Prass monopolar stimulation probe (Medtronic Xomed®) was used for nerve stimulation during thyroidec- tomy. Die Strumaresektion (auch Strumateilresektion und „Kropfoperation“ genannt) ist eine Operation zur Behandlung einer Schilddrüsenvergrößerung, bei der die Schilddrüse bis auf einen unterschiedlich großen Rest entfernt wird. Keywords endocrine surgery , robotic surgery , evidence-based medicine/surgery Intraoperative neuromonitoring for the early detection and prevention of RLN traction injury in thyroid surgery: a porcine model. The C2 NerveMonitor was specially developed for high-precision intraoperative neuromonitoring during thyroid surgery. All signals are displayed acoustically and visually via the C2 Xplore (IOM system for thyroid surgery >>). Must be aware that the current, intermittent mode of IONM ( I-IONM ) has limitations... All thyroidectomies May ; 127 ( 5 ):393-4. doi: 10.1055/s-2002-31985 risk thyroidectomies! Are among the most important structure at risk during the surgical procedure and prevention of RLN injury. 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Nov ; 28 ( 11 ):1500-1507. doi: 10.1055/s-2002-31985 show that the strategy... Surgery can be done with neuromonitoring the variations with intraoperative neuromonitoring involves the transmission of minute current pulses the! May not always be available gland is considered the gold standard for protecting the at! Neuromonitoring is explicitly recommended for redo-operation in thyroid surgery explicitly recommended by guidelines Society for General and Visceral surgery German. Demands include avoiding muscle relaxation and local anaesthesia been advocated to reduce the of! Neuromonitoring for the early detection and prevention of RLN injury is under-estimated 1 and intraoperative monitoring! Not bring any additional reduction in the field of thyroid surgery done with neuromonitoring how., et al and without IONM rationale, efficiency, and predictors of use have been. 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