Prospective study of vocal fold function after loss of the neuromonitoring signal in thyroid surgery: The International Neural Monitoring Study Group's POLT study

Abstract

2b Laryngoscope, 126:1260-1266, 2016.

Opportunities and challenges of intermittent and continuous intraoperative neural monitoring in thyroid surgery

“…These findings suggest that an injured nerve be given a minimum wait of 20 minutes after LOS has set in to recover ≥50% of its baseline amplitude before moving on with completion thyroidectomy on the unaffected side (48). Indeed, as many as 85% of segmental RLN injuries type 1 and 94% of global RLN injuries type 2 recovered completely within half a year (47).…”

“…CIONM helps detect adverse EMG changes early on and prevent severe RLN injuries that cause LOS by permitting the surgeon to release distressed nerves (20,45,46). RLN injury comes in two varieties, which differ in many ways (47):…”

“…Further research should be targeted at further clarifying causation, histopathological nerve damage, and the clinical consequences of segmental nerve injury type 1 and global nerve injury type 2 (17,47). On a cautionary note, animal studies may not be fully generalizable to humans, leaving room for interpretation (31).…”

Loss of signal during intraoperative neuromonitoring of laryngeal nerves as a predictor of postoperative larynx paresis: Analysis of 1065 consequetive thyroid and parathyroid operations. Surgeons' algorythm (tactics)

“…7) и глобальный (рис. 8) [10]. Протоколирование результатов ИОНМ гортанных и блуждающих нервов произво-дили в соответствии с алгоритмом, представ-ленным в табл.…”

“…Остальные показате-ли были следующими: специфичность -99,7% (Sp), положительная прогностическая значимость (PPV) -91,8% и отрицательная прогностическая значимость (NPV) -97,8% для потери сигнала и развития в после-операционном периоде пареза гортани, что сопоставимо с данными зарубежных авторов [10].…”