Abstract
Intraoperative neural monitoring (IONM) of the recurrent laryngeal nerve (RLN) during thyroid surgery has gained widespread acceptance as an adjunct to the gold standard of visual nerve identification. IONM may be used for identification of the RLN, aid in the dissection of the RLN, and be used to anticipate postoperative neural function. This is of great significance in the prevention of bilateral nerve paralysis. In the case of nerve injury, the IONM may be used to identify the exact segment of nerve injured. The potential for reduced visual information during minimally invasive thyroid and parathyroid surgery procedure has led to the great application of neural monitoring in those cases. The use of a flexible tip of a monopolar stimulation probe allows good access to neural structures in areas outside the surgeon’s field of view. IONM in minimally invasive technique probably enables surgeons to feel more confident, indicates the correct plane of dissection, and may reduce the conversion rate to an open technique.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Angelos P (2009) Recurrent laryngeal nerve monitoring: state of the art, ethical and legal issues. Surg Clin North Am 89(5):1157–1169
Dedo HH (1970) The paralyzed larynx: an electromyographic study in dogs and humans. Laryngoscope 80(10):1455–1517
Dionigi G, Bacuzzi A, Boni L, Rovera F, Dionigi R (2008) What is the learning curve for intraoperative neuromonitoring in thyroid surgery? Int J Surg 6(Suppl 1):S7–S12
Dionigi G, Boni L, Rovera F, Bacuzzi A, Dionigi R (2009) Neuromonitoring and video-assisted thyroidectomy: a prospective, randomized case–control evaluation. Surg Endosc 23(5):996–1003
Dralle H, Sekulla C, Haerting J, Timmermann W, Neumann HJ, Kruse E et al (2004) Risk factors of paralysis and functional outcome after recurrent laryngeal nerve monitoring in thyroid surgery. Surgery 136(6):1310–1322
Dralle H, Sekulla C, Lorenz K, Brauckhoff M, Machens A (2008) Intraoperative monitoring of the recurrent laryngeal nerve in thyroid surgery. World J Surg 32(7):1358–1366
Kandil E, Wassef SN, Alabbas H, Freidlander PL (2009) Minimally invasive video-assisted thyroidectomy and parathyroidectomy with intraoperative recurrent laryngeal nerve monitoring. Int J Otolaryngol 2009:739798
Lahey FH, Hoover WB (1938) Injuries to the recurrent laryngeal nerve in thyroid operations: their management and avoidance. Ann Surg 108(4):545–562
Myssiorek D (2004) Recurrent laryngeal nerve paralysis: anatomy and etiology. Otolaryngol Clin North Am 37(1):25–44, v
Randolph GW (2003) Surgical anatomy of the recurrent laryngeal nerve. In: Randolph GW (ed) Surgery of the thyroid and parathyroid glands. Elsevier Science, Philadelphia
Randolph GW, Kamani D (2006) The importance of preoperative laryngoscopy in patients undergoing thyroidectomy: voice, vocal cord function, and the preoperative detection of invasive thyroid malignancy. Surgery 139(3):357–362
Randolph GW, Dralle H, Abdullah H, Barczynski M, Bellantone R, Brauckhoff M et al (2011) Electrophysiologic recurrent laryngeal nerve monitoring during thyroid and parathyroid surgery: international standards guideline statement. LaryÂngoscope 121(Suppl 1):S1–S16
Terris DJ, Anderson SK, Watts TL, Chin E (2007) Laryngeal nerve monitoring and minimally invasive thyroid surgery: complementary technologies. Arch Otolaryngol Head Neck Surg 133(12):1254–1257
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Mekel, M., Randolph, G.W. (2012). Intraoperative Nerve Stimulation in Minimally Invasive Thyroidectomy. In: Linos, D., Chung, W. (eds) Minimally Invasive Thyroidectomy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-23696-9_20
Download citation
DOI: https://doi.org/10.1007/978-3-642-23696-9_20
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-23695-2
Online ISBN: 978-3-642-23696-9
eBook Packages: MedicineMedicine (R0)