2021
DOI: 10.1002/hed.26895
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Success rate and learning curve of intraoperative neural monitoring of the external branch of the superior laryngeal nerve in thyroidectomy

Abstract: Background: This study aimed to evaluate the success rate and learning curve of intraoperative neural monitoring (IONM) of the external branch of the superior laryngeal nerve (EBSLN) in thyroidectomy.Methods: We studied 130 consecutive patients (200 nerves at risk [NARs]) who had undergone conventional thyroidectomy with IONM of the recurrent laryngeal nerve (RLN) and EBSLN from January 2017 to March 2020. The learning curve was defined as the number of NARs required to achieve an effective and reliable neurom… Show more

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Cited by 3 publications
(4 citation statements)
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“…In literature the LC required for correct use of IONM is mutable and has been reported to be around 45-50 procedures. 14,15 In detail, it was seen that the variability is partly due to the experience of the surgeons, being longer for the more experienced, probably due to the difficulty in integrating a new skill into an already consolidated technique. Few authors have investigated how and to what extent the use of this tool influences the technique during thyroidectomy.…”
Section: Discussionmentioning
confidence: 99%
“…In literature the LC required for correct use of IONM is mutable and has been reported to be around 45-50 procedures. 14,15 In detail, it was seen that the variability is partly due to the experience of the surgeons, being longer for the more experienced, probably due to the difficulty in integrating a new skill into an already consolidated technique. Few authors have investigated how and to what extent the use of this tool influences the technique during thyroidectomy.…”
Section: Discussionmentioning
confidence: 99%
“…In this study, the V1 signal of the contralateral RLN was measured in all patients, and there was no statistical difference compared with the signal value of the affected side (P>0.05) (Table 2). Because it is impossible to distinguish the RLN and VN based on their anatomical positions when monitoring the signals of the contralateral nerves, we can distinguish them based on the latency of the signal value of nerve monitoring (18)(19)(20)(21). The latency of the ipsilateral VN is slightly longer than that of the RLN, so the monitored nerve can be better identified intuitively.…”
Section: Discussionmentioning
confidence: 99%
“…Although some believe that experienced surgeons benefit less from IONM and that simple avoidance of the EBSLN is equally effective in protecting nerve function, detection of the EBSLN may be useful, especially in the above cases. The reported visual detection rate of EBSLN during thyroidectomy is 21.2–98.3%, but has significantly increased with the help of IONM ( 18 ). By separating the space of the SCM branches (between the sternal and clavicular heads), SMIA thyroidectomy pulls the sternal thyroid muscle upward and medially away from the surface of the gland, allowing the extreme surgical field to be fully exposed without cutting off the sternal thyroid muscle and increasing collateral damage.…”
Section: Discussionmentioning
confidence: 99%
“…Since then, the use of this technique has become increasingly widespread and the number of centers performing operations with IONM continues to grow ( 74 , 75 ). Numerous publications show a high rate of RLN identification with IONM and several studies investigate the LC for IONM ( 76 - 82 ). However, no study focuses on how much the IONM use affects the surgeon’s LC.…”
Section: Methodsmentioning
confidence: 99%