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European Archives of Oto-Rhino-Laryngology

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01-09-2013 | Review Article

Neuromonitoring of the laryngeal nerves in thyroid surgery: a critical appraisal of the literature

Authors: Alvaro Sanabria, Carl E. Silver, Carlos Suárez, Ashok Shaha, Avi Khafif, Randall P. Owen, Alessandra Rinaldo, Alfio Ferlito

Published in: European Archives of Oto-Rhino-Laryngology | Issue 9/2013

Abstract

One of the most significant complication of thyroid surgery is injury of the recurrent laryngeal nerve. Injury of the external branch of the superior laryngeal nerve is a less obvious but occasionally significant problem. Recently, neuromonitoring during thyroidectomy has received considerable attention because of literature encouraging its use, but there is no consensus about its advantages and utility. A critical assessment of the literature on neuromonitoring was conducted in order to define its effectiveness, safety, cost-effectiveness and medical-legal impact. Available data does not show results superior to those obtained by traditional anatomical methods of nerve identification during thyroid surgery. Data about cost-effectiveness is scarce. The literature shows inconsistencies in methodology, patient selection and randomization in various published studies which may confound the conclusions of individual investigations. The current recommendation for use in “high risk” patients should be assessed because definition heterogeneity makes identification of these patients difficult. As routine use of neuromonitoring varies according to geography, its use should not be considered to be the standard of care.

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Title: Neuromonitoring of the laryngeal nerves in thyroid surgery: a critical appraisal of the literature
Authors: Alvaro Sanabria
Carl E. Silver
Carlos Suárez
Ashok Shaha
Avi Khafif
Randall P. Owen
Alessandra Rinaldo
Alfio Ferlito
Publication date: 01-09-2013
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 9/2013
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-013-2558-1

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Neuromonitoring of the laryngeal nerves in thyroid surgery: a critical appraisal of the literature

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