Abstract

SANABRIA, Álvaro. Evidence of the applicability of intermittent neuromonitoring in thyroid surgery. rev. colomb. cir. [online]. 2015, vol.30, n.3, pp.220-229. ISSN 2011-7582.

Thyroidectomy is the most frequent surgical procedure performed on the neck and is associated with a low number of complications. The rate of definitive injury of the recurrent laryngeal nerve is lower than 1%, of definitive hypoparathyroidism is around 1-2%, and of neck hematoma is lower than 0.5%. The incidence of bilateral recurrent laryngeal nerve injury needing tracheostomy is lower than 0.2%. For more than a decade there have appeared reports suggesting that intermittent neuromonitoring is a strategy to decrease even more the risk of laryngeal nerve injuries. This review discusses the available evidence about the effectiveness of intermittent neuromonitoring in thyroidectomy. Five of six systematic reviews concluded that there is no evidence of a statistically significant decrease in the rate of laryngeal nerves injuries with the routine use of neuromonitoring. Most authors agree that the device will be useful in high risk patients, but definition of high risk is heterogeneous and unclear. Routine use of monitoring offers a minor advantage in decision making during surgery, especially when a loss of signal occurs. Besides, there is no evidence that neuromonitoring decreases the number of medico legal issues.

Keywords : thyroid gland; thyroidectomy; recurrent laryngeal nerve; neural conduction; monitoring; intraoperative; risk factors.

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