Electrophysiological neural monitoring of the laryngeal nerves in thyroid surgery: review of the current literature.
Citations
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References
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"Electrophysiological neural monitor..." refers background or methods in this paper
...The German Association of Endocrine Surgeons practice guidelines and the International Neural Monitoring Study Group guidelines both support using IONM in all thyroid surgeries (23,34), while the American Head and Neck Society endorses its utilization in thyroid cancer cases, particularly patients with RLN palsy....
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...The International Neural Monitoring Study Group classified nerve injury into two categories: segmental, which involves a lesion to a clear-cut segment of the RLN, and global, where all the RLN and vagus are nonconductive which may indicate an intralaryngeal focus of injury (23)....
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...Prolonged latency time can be used in combination with decreased amplitude or complete LOS as an indicator of nerve injury (23,40)....
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...Due to its safety and simplicity, it is superior to other modalities as glottic observation, laryngeal palpation, postcricoid surface electrodes and intramuscular electrodes (23)....
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...Furthermore, it can detect the most proximal RLN or EBSLN injuries (23)....
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592 citations
"Electrophysiological neural monitor..." refers background in this paper
...IONM can diagnose nonRLN which has shorter latency time compared to the recurrent nerve (11)....
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...It was reported that IONM can reduce the rate of transient RLN injury in thyroid surgery (11,28,29)....
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...Intraoperative visual identification has been the gold standard for securing the laryngeal nerves during thyroid surgery (10-12)....
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...reported that running a statistically powerful study would require millions of patients (11)....
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Additional excerpts
...In bilateral surgery, when nerve injury is detected by IONM on the initial side, the procedure could be staged by postponing operation on the other side until vocal cord function can be verified (41,42)....
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