The role of intraoperative neural monitoring versus identification alone on post-thyroidectomy true vocal cord palsy

Abstract

INTRODUCTION:The most critical and undesirable complication of thyroid surgery is recurrent laryngeal nerve palsy which can be significantly deteriorate the quality of life. Although intraoperative neu-romonitoring (IONM) has been introduced as a new technique to prevent recurrent laryngeal nerve damage, the benefits of IONM are still controversial. The aim of this study was to dis-cuss the postoperative complication rates of thyroid surgery with and without intraoperative neural monitoring in the context of the literature.METHODS:The patients were divided into two groups; IONM used group (Group 1, n: 72) and conven-tional directvisualtechniquewithoutIONM group(Group2,n:276).Age,sex,preoperativediagnosis, ultrasonographic findings, type of surgery, duration of surgery, postoperative calci-um, parathormone levels, and early postoperative complications were recorded.RESULTS:There was no significant difference between twogroups regarding age, gender, operation type, total hospitalization period, postoperative calcium, parathormone levels, and preopera-tive diagnoses. Postoperative bleeding and hoarseness were determined in 6 (2.2%) patients and 3 (1.1%) patients in group 2 respectively. However postoperative bleeding and hoarseness were determined in 1 patient in group 1. Hypocalcemia was determinedin9(12.5%)patientsingroup1andin48(17.4%)patientsingroup2(p=0.24). DISCUSSION AND CONCLUSION:We did not determine a significant effect of IONM on postoperative complication rates