Trends in Intraoperative Neuromonitoring for Thyroid Surgery: A Point-Prevalence Survey in Korea

Abstract

Background and Objectives To determine the trends in the use of intraoperative recurrent laryngeal nerve (RLN) monitoring during thyroid surgery in Korea. Materials and Methods A web-based anonymous survey was sent to 594 members of the Korean Intraoperative Neural Monitoring Society (KINMoS), who perform thyroid surgeries in Korea. Topics included in the survey covered the demographics, practice setting, surgical volume, access and familiarity with intraoperative neuromonitoring (IONM) technology, use of IONM, perceived advantages or disadvantages, and qualitative and quantitative descriptions of IONM usage. The χ² test was used to examine associations between the use of IONM and dependent variables. Results A total of 78 (13.1%) people completed the survey. Of the respondents, 78.1% answered that they use IONM in at least some thyroid cases: 28% answered that they always use it and 50% used it occasionally. The most common reason for using IONM was because “it is helpful in special cases,” while “cost” was the most common reason for not using IONM. Among the study population, surgeons in tertiary hospitals and those with high surgical volumes used IONM frequently. Surgeons using IONM were often involved in medical education and were more likely to recommend the use of IONM. Statistical correlation was also confirmed between laryngeal examination and IONM utilization. Conclusion IONM is used for thyroid surgeries at a relatively high rate in Korea. Its use is associated with training, hospital setting of the current surgical practice, annual number of surgeries, involvement in medical training/education, familiarity with IONM, and device availability.