Laryngeal nerve monitoring and minimally invasive thyroid surgery: complementary technologies.

Journal Article (Journal Article)

OBJECTIVE: To determine the feasibility of the combined use of laryngeal nerve monitoring and minimally invasive thyroid surgery. DESIGN: Prospective, nonrandomized analysis of single-surgeon experience. SETTING: Academic institution. PATIENTS: Consecutive series of patients undergoing both minimally invasive thyroid surgery and laryngeal nerve monitoring. MAIN OUTCOME MEASURES: Incision length and incidence of temporary or permanent laryngeal nerve injury. RESULTS: Two hundred eighty-three patients underwent thyroid surgery at the Medical College of Georgia, Augusta, between January 2004 and November 2006. Some type of minimal-access approach (endoscopic or nonendoscopic) was used in 137 cases (48.4%) in which general anesthesia was administered. Laryngeal nerve monitoring was performed in 73 (53.3%) of these 137 cases, although the proportion of cases in which it was performed increased significantly from 8.7% (2 of 23 cases) in 2004 to 95.2% (58 of 61 cases) in 2006 (P < .001). There were no cases of permanent nerve injury. The incidence of temporary recurrent laryngeal nerve paresis was 4.3% (4 of 92 nerves at risk) in the cases in which laryngeal nerve monitoring was used and 6.0% (5 of 84 nerves at risk) in the cases in which the nerve was visually identified without use of a monitor. This difference failed to reach statistical significance (P = .73), which may reflect an insufficient sample size. CONCLUSION: Monitoring of the laryngeal nerves is feasible in minimal-access thyroid surgery and may serve as a meaningful adjunct to the visual identification of nerves.

Full Text

Duke Authors

Cited Authors

  • Terris, DJ; Anderson, SK; Watts, TL; Chin, E

Published Date

  • December 2007

Published In

Volume / Issue

  • 133 / 12

Start / End Page

  • 1254 - 1257

PubMed ID

  • 18086968

International Standard Serial Number (ISSN)

  • 0886-4470

Digital Object Identifier (DOI)

  • 10.1001/archotol.133.12.1254

Language

  • eng

Conference Location

  • United States