标题：Continuous intraoperative neuromonitoring (CIONM) of the recurrent laryngeal nerve is sufficient as the only neuromonitoring technique in thyroidectomy performed because of benign goitre
期刊名称：Annals of Agricultural and Environmental Medicine
印刷版ISSN：1232-1966
电子版ISSN：1898-2263
出版年度：2015
卷号：22
期号：3
页码：495-498
DOI：10.5604/12321966.1167722
出版社：Institute of Agricultural Medicine in Lublin
摘要：Introduction. Recently, intraoperative neurophysiological neuromonitoring (IONM) of recurrent laryngeal nerves (RLN)has been evolving quickly. This evolution touched many aspects of the technique, leading to continuous stimulation of theRLN with real time analysis of the electrical signal.Objective. The aim of the study was to estimate the value of continuous intraoperative neuromonitoring (CIONM) as theonly technique for intraoperative neuromonitoring in thyroidectomy performed because of benign goitre.Material and methods. The study comprised 80 women qualified for thyroidectomy due to nodular goitre. The patientswere divided into 4 groups depending on the technique used for RLN integrity verification: group 1 – thyroidectomy withCIONM; group 2 – thyroidectomy with direct, intermittent stimulation of RLN and vagus nerve (NX); group 3 – both CIONMand intermittent stimulation of RLN and NX; group 4 – thyroidectomy without any IONM.Results. Mean operation time did not differ significantly among the groups with IONM, but was significantly longerin comparison to group 4, as well as the operation’s cost. In the analysed groups there was no significant difference incomplication ratio.Conclusion. CIONM with RLN visualization in thyroidectomy performed because of benign goitre is as safe as other methodsof IONM and gives a continuous confirmation of the electrical integrity of the loop NX-RLN-vocal folds during almost theentire procedure. There is a clinical need for the development of external stimulation of NX (transdermal or trancranial),particularly for minimally invasive techniques in which access to NX is limited (i.e. transoral thyroidectomy).
