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Recurrent laryngeal nerve paresis in benign thyroid surgery with and without intraoperative nerve monitoring

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Recurrent laryngeal nerve paresis in benign thyroid surgery with and without intraoperative nerve monitoring. / Grishaeva, Polina; Kussmann, Jochen; Burgstaller, Thomas; Klutmann, Susanne; Linder, Kirsten; Fendrich, Volker.

In: MINERVA SURG, Vol. 77, No. 6, 12.2022, p. 558-563.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Grishaeva, P, Kussmann, J, Burgstaller, T, Klutmann, S, Linder, K & Fendrich, V 2022, 'Recurrent laryngeal nerve paresis in benign thyroid surgery with and without intraoperative nerve monitoring', MINERVA SURG, vol. 77, no. 6, pp. 558-563. https://doi.org/10.23736/S2724-5691.22.09421-7

APA

Grishaeva, P., Kussmann, J., Burgstaller, T., Klutmann, S., Linder, K., & Fendrich, V. (2022). Recurrent laryngeal nerve paresis in benign thyroid surgery with and without intraoperative nerve monitoring. MINERVA SURG, 77(6), 558-563. https://doi.org/10.23736/S2724-5691.22.09421-7

Vancouver

Grishaeva P, Kussmann J, Burgstaller T, Klutmann S, Linder K, Fendrich V. Recurrent laryngeal nerve paresis in benign thyroid surgery with and without intraoperative nerve monitoring. MINERVA SURG. 2022 Dec;77(6):558-563. https://doi.org/10.23736/S2724-5691.22.09421-7

Bibtex

@article{763cde797be7493fa2b668eb2f040dcf,
title = "Recurrent laryngeal nerve paresis in benign thyroid surgery with and without intraoperative nerve monitoring",
abstract = "BACKGROUND: Recurrent laryngeal nerve (RLN) paresis is a rare but serious complication in thyroid surgery. Intermittent intraoperative nerve monitoring (IONM) was thought to prevent paresis of the RLN, but until today data are not conclusive. Our objective was to confirm the hypothesis that IONM can reduce paresis of RLN compared to nerve visualization alone. Therefore, we examined one of the largest cohorts ever evaluated of a tertiary referral center for endocrine surgery undergoing thyroid surgery for benign thyroid disease.METHODS: Overall, 2097 patients who underwent thyroid surgery for benign thyroid disease in 2016 and 2017 were evaluated. RLN was identified by IONM or visualization only. Preoperative and postoperative laryngoscopic examination was used to evaluate RLN paresis. Patients' characteristics and perioperative data were extracted retrospectively.RESULTS: Overall, 1963 patients (2720 nerves at risk [NAR]) were included in this study: 378 surgeries with IONM (560 NAR) and 1585 without IONM (2160 NAR). Transient and permanent RLN pareses were found in 13 (3.4%; NAR=2.3%) and one (0.3%; NAR=0.2%) nerve treated with IONM vs. 37 (2.3%; NAR=1.7%) and five (0.3%; NAR=0.2%) nerves without IONM (P=0.507; NAR P=0.654), respectively.CONCLUSIONS: Using intermittent IONM, our retrospective study could not demonstrate a significant decrease of RLN pareses in patients undergoing thyroid surgery for benign thyroid disease. This is probably explained by the very low overall number of RLN pareses in our department. Nevertheless, because of patients' safety to avoid any bilateral RLN pareses, we recommend IONM in bilateral resections.",
keywords = "Humans, Recurrent Laryngeal Nerve, Recurrent Laryngeal Nerve Injuries/diagnosis, Thyroidectomy/adverse effects, Retrospective Studies, Monitoring, Intraoperative/adverse effects, Thyroid Diseases/surgery, Paresis/complications",
author = "Polina Grishaeva and Jochen Kussmann and Thomas Burgstaller and Susanne Klutmann and Kirsten Linder and Volker Fendrich",
year = "2022",
month = dec,
doi = "10.23736/S2724-5691.22.09421-7",
language = "English",
volume = "77",
pages = "558--563",
journal = "MINERVA SURG",
issn = "2724-5691",
publisher = "Edizioni Minerva Medica S.p.A.",
number = "6",

}

RIS

TY - JOUR

T1 - Recurrent laryngeal nerve paresis in benign thyroid surgery with and without intraoperative nerve monitoring

AU - Grishaeva, Polina

AU - Kussmann, Jochen

AU - Burgstaller, Thomas

AU - Klutmann, Susanne

AU - Linder, Kirsten

AU - Fendrich, Volker

PY - 2022/12

Y1 - 2022/12

N2 - BACKGROUND: Recurrent laryngeal nerve (RLN) paresis is a rare but serious complication in thyroid surgery. Intermittent intraoperative nerve monitoring (IONM) was thought to prevent paresis of the RLN, but until today data are not conclusive. Our objective was to confirm the hypothesis that IONM can reduce paresis of RLN compared to nerve visualization alone. Therefore, we examined one of the largest cohorts ever evaluated of a tertiary referral center for endocrine surgery undergoing thyroid surgery for benign thyroid disease.METHODS: Overall, 2097 patients who underwent thyroid surgery for benign thyroid disease in 2016 and 2017 were evaluated. RLN was identified by IONM or visualization only. Preoperative and postoperative laryngoscopic examination was used to evaluate RLN paresis. Patients' characteristics and perioperative data were extracted retrospectively.RESULTS: Overall, 1963 patients (2720 nerves at risk [NAR]) were included in this study: 378 surgeries with IONM (560 NAR) and 1585 without IONM (2160 NAR). Transient and permanent RLN pareses were found in 13 (3.4%; NAR=2.3%) and one (0.3%; NAR=0.2%) nerve treated with IONM vs. 37 (2.3%; NAR=1.7%) and five (0.3%; NAR=0.2%) nerves without IONM (P=0.507; NAR P=0.654), respectively.CONCLUSIONS: Using intermittent IONM, our retrospective study could not demonstrate a significant decrease of RLN pareses in patients undergoing thyroid surgery for benign thyroid disease. This is probably explained by the very low overall number of RLN pareses in our department. Nevertheless, because of patients' safety to avoid any bilateral RLN pareses, we recommend IONM in bilateral resections.

AB - BACKGROUND: Recurrent laryngeal nerve (RLN) paresis is a rare but serious complication in thyroid surgery. Intermittent intraoperative nerve monitoring (IONM) was thought to prevent paresis of the RLN, but until today data are not conclusive. Our objective was to confirm the hypothesis that IONM can reduce paresis of RLN compared to nerve visualization alone. Therefore, we examined one of the largest cohorts ever evaluated of a tertiary referral center for endocrine surgery undergoing thyroid surgery for benign thyroid disease.METHODS: Overall, 2097 patients who underwent thyroid surgery for benign thyroid disease in 2016 and 2017 were evaluated. RLN was identified by IONM or visualization only. Preoperative and postoperative laryngoscopic examination was used to evaluate RLN paresis. Patients' characteristics and perioperative data were extracted retrospectively.RESULTS: Overall, 1963 patients (2720 nerves at risk [NAR]) were included in this study: 378 surgeries with IONM (560 NAR) and 1585 without IONM (2160 NAR). Transient and permanent RLN pareses were found in 13 (3.4%; NAR=2.3%) and one (0.3%; NAR=0.2%) nerve treated with IONM vs. 37 (2.3%; NAR=1.7%) and five (0.3%; NAR=0.2%) nerves without IONM (P=0.507; NAR P=0.654), respectively.CONCLUSIONS: Using intermittent IONM, our retrospective study could not demonstrate a significant decrease of RLN pareses in patients undergoing thyroid surgery for benign thyroid disease. This is probably explained by the very low overall number of RLN pareses in our department. Nevertheless, because of patients' safety to avoid any bilateral RLN pareses, we recommend IONM in bilateral resections.

KW - Humans

KW - Recurrent Laryngeal Nerve

KW - Recurrent Laryngeal Nerve Injuries/diagnosis

KW - Thyroidectomy/adverse effects

KW - Retrospective Studies

KW - Monitoring, Intraoperative/adverse effects

KW - Thyroid Diseases/surgery

KW - Paresis/complications

U2 - 10.23736/S2724-5691.22.09421-7

DO - 10.23736/S2724-5691.22.09421-7

M3 - SCORING: Journal article

C2 - 35230041

VL - 77

SP - 558

EP - 563

JO - MINERVA SURG

JF - MINERVA SURG

SN - 2724-5691

IS - 6

ER -