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

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 direct visual technique without IONM group (Group 2, n: 276). Age, sex, preoperative diagnosis, 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 two groups 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 determined in 9 (12.5%) patients in group 1 and in 48 (17.4%) patients in group 2 (p= 0.24).
DISCUSSION AND CONCLUSION: We did not determine a significant effect of IONM on postoperative complication rates.

Tiroidektomi sonrasý gerçek vokal kord palsisinde tek baþýna direk bakýya karþý in-traoperatif nöral monitörizasyonun rolü

GÝRÝÞ ve AMAÇ: Amaç: Tiroid cerrahisinin en kritik ve istenmeyen, yaþam kalitesini önemli ölçüde azaltabilen komplikasyonu rekürren laringeal sinir felcidir. Ýntraoperatif nöromonitorizasyonu (IONM), rekürren laringeal sinir hasarýný önlemek için yeni bir teknik olarak tanýtýlmýþ olmasýna raðmen, IONM'nin yararlarý hala tartýþmalýdýr. Bu çalýþmanýn amacý, tiroid cerrahisinin postoperatif komplikasyon oranlarýný intraoperatif nöral izlemeli kulanýlan veya kullanýlmayan vakalarda literatür eþliðinde tartýþmaktýr.
YÖNTEM ve GEREÇLER: Hastalar iki gruba ayrýldý; IONM kullanýlan grup (Grup 1, n: 72) ve IONM grubu olmayan geleneksel direkt görsel teknik kullanýlan grup (Grup 2, n: 276). Yaþ, cinsiyet, preoperatif taný, ultrasonografik bulgular, ameliyat türü, ameliyat süresi, postoperatif kalsiyum, parathormon düzeyleri ve erken postoperatif komplikasyonlar kaydedildi.
BULGULAR: Ýki grup arasýnda yaþ, cinsiyet, ameliyat tipi, hastanede kalýþ süresi, postoperatif kalsiyum, parathormon düzeyleri ve preoperatif taný açýsýndan anlamlý fark yoktu. Postoperatif kanama ve ses kýsýklýðý sýrasýyla 6 (% 2.2) hastada ve 3 (% 1.1) hastada grup 2'de belirlendi. Bununla birlikte postoperatif kanama ve ses kýsýklýðý 1.grupta 1 hastada belirlendi. Hipokalsemi, grup 1'de 9 (% 12.5), grup 2'de 48 (% 17.4) hastada (p= 0.24) belirlendi.
TARTIÞMA ve SONUÇ: IONM'nin postoperatif komplikasyon oranlarý üzerine anlamlý bir etkisi saptamadýk