Abstract
Feasibility of intraoperative nerve monitoring (IONM) in endoscopic thyroid surgery
Highlights
A major obstacle to the acceptability of scarless endoscopic thyroid surgery (SET) amongst surgeons is the perceived potential of nerve injury in the absence of seamless Intraoperative Nerve Monitoring (IONM)
All operations were performed by two surgeons (ADR, RMS) who were well experienced with conventional thyroidectomy and minimally invasive surgical techniques
8 recurrent laryngeal nerve (RLN)’s were visualised positively (32% overall). 4 out of 8 RLN’s that were visualised positively had their focussed dissection directly aid positive visual identification thereby having their success attributable to IONM, whereas the other 4 RLN’s after initial stimulation using the IONM could not be visualised by directed dissection attempts and were subsequently visualised by dissection unaided by IONM. 12 out of 25 (48%) external laryngeal nerve (ELN)’s were accurately electrically stimulated
Summary
A major obstacle to the acceptability of scarless endoscopic thyroid surgery (SET) amongst surgeons is the perceived potential of nerve injury in the absence of seamless Intraoperative Nerve Monitoring (IONM). Attempts have been made to reduce the cosmetic impact of the cervical scar by a reduction in incision size and even development of video-assisted and totally endoscopic surgeries. The pursuit of cosmesis has led surgeons to push the envelope even further and Scarless (in the neck) Endoscopic Thyroidectomy (SET) has found an increasing role in the realm of thyroid surgery. It has excellent cosmetic results [5,6]
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