Association between Intraoperative Nerve Monitoring and the Duration of Thyroid Surgery

Abstract

Background: Recurrent laryngeal nerve (RLN) injury is one of the serious complications of thyroid surgeries, which has been a topic of medicolegal concern. Although the course of the nerve can vary between patients, RLN visualization has been the gold standard method for identifying the nerve intraoperatively. However, over recent years, intraoperative nerve monitoring (IONM) has gained more acceptance and has been standardized and utilized, in addition to visual nerve identification, in many thyroids and parathyroid surgery centers. In this study, we aim to determine the association between the use of nerve integrity monitoring systems and the duration of thyroid surgery. Materials and Methods: This is a retrospective chart review, conducted at hospital in Jeddah, Saudi Arabia. We included all patients who underwent thyroid surgery during the period between 2014 and 2019, with no exclusion criteria. We studied variables including duration of surgery, preoperative assessment, diagnosis, surgical procedure, use of IONM, and comorbidities. Results: A total of 236 patients were included, of which 69 (29.2%) cases used IONM. The mean duration of all surgeries was 179.95 ± 96.9 min, whereas the mean duration of surgeries using IONM only was 214.39 min, compared to 165.72 min of surgeries without IONM, which reveals a statistically significant association between the use of nerve monitoring and an increase in the duration of surgery (P ≤0.002). Conclusion: IONM utilization in thyroid surgeries was associated with a longer duration of surgery. However, more studies are required to support this result.