Intaoperative neuromonitoring in thyroid surgery

Abstract

Thyroid surgery is most frequent interventions on endocrine organs. Whereas laryngeal nerves which inner vate the muscles of larynx are passing nearby the thyroid and central compartment therefore the risk of their injury and functional integrity is extremely important. First of all it is recurrent laryngeal nerve which in 0.5–2.7% has not “recurrent” path and depart vagus at cricoid cartilage level. Secondary it is external branch of superior laryngeal nerve with innervates cricothyroid muscle. Routine use of intraoperative neuromonitoring significantly decrease laryngeal nerves temporary palsy (paresis) rate however significant reduction of perma nent palsy frequency was not demonstrated in most published papers. At the same time all authors accept that intraoperative neuromonitoring undoubtedly facilitate detection of laryngeal nerves and allow to convince their functional capacity. Taking into account that safety is a paradigm of contemporary endocrine surgery the intra operative neuromonitoring going towards further investigation and improvement.