Tips and pitfalls of intraoperative neuromonitoring to avoid nerve injury during thyroid surgery

Ji, Yong Bae

doi:2021.1.1.1

J Neuromonit Neurophysiol > Volume 1(1); 2021 > Article

Review article

Journal of Neuromonitoring & Neurophysiology 2021;1(1):1-7.
DOI: https://doi.org/10.54441/jnn.2021.1.1.1 Published online November 30, 2021.

갑상선 수술 중 신경 손상을 피하기 위한 수술 중 신경 모니터링의 활용

지용배

Tips and pitfalls of intraoperative neuromonitoring to avoid nerve injury during thyroid surgery

Yong Bae Ji

Abstract

Traditionally, visual identification of the nerve is the gold standard to avoid injury. Intraoperative neural monitoring (IONM) has been world-widely popularized in thyroid and parathyroid surgery because it helps identify the nerve. Despite the increasing use of IONM, there is a controversy that IONM can reduce recurrent laryngeal nerve (RLN) injury. It may be derived from the lack of uniformity in the application of and results from nerve monitoring between surgeons. IONM can not only be used to check the nerves, but it can also provide a lot of information to the surgeon. By using this information properly, the function of nerves can be monitored sensitively during surgery, and through this, a surgeon can be relatively freed from nerve damage. Proper use of IONM can improve the quality of neural monitoring and drive surgeons to best practices. In this paper, consistent and useful use of IONM has been described.

Key Words: Recurrent laryngeal nerve, Intraoperative neuromonitoring, Thyroid surgery, Electromyography, Loss of signal