“The final countdown”: Is intraoperative, intermittent neuromonitoring really useful in preventing permanent nerve palsy? Evidence from a meta-analysis

Lombardi, Celestino Pio; Carnassale, Giulia; Damiani, Gianfranco; Acampora, Anna; Raffaelli, Marco; Crea, Carmela De; Bellantone, Rocco Domenico Alfonso

doi:10.1016/j.surg.2016.06.049

Cited by 55 publications

(55 citation statements)

References 37 publications

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“…Lombardi et al . gave a negative conclusion about the protective effects of IONM on permanent injury 18 . Wong et al .…”

Section: Discussionmentioning

confidence: 99%

“…Some results found that IONM could reduce transient RLN injury, while other results revealed non-significant help of IONM in RLN injury prevention 4 , 14 , 15 . Several meta-analyses have been conducted to discuss this topic 12 , 13 , 16 – 18 . Most of these studies found that IONM was not superior to visual identification in preventing permanent RLN injury 12 , 18 .…”

Section: Introductionmentioning

confidence: 99%

“…Several meta-analyses have been conducted to discuss this topic 12 , 13 , 16 – 18 . Most of these studies found that IONM was not superior to visual identification in preventing permanent RLN injury 12 , 18 . Some results indicated that IONM could decrease RLN injury incidence in high risk thyroid surgery, particularly in cancer operations or in those with a previous history of neck operation 17 .…”

Section: Introductionmentioning

confidence: 99%

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Protective Effects of Intraoperative Nerve Monitoring (IONM) for Recurrent Laryngeal Nerve Injury in Thyroidectomy: Meta-analysis

Bai

Chen

2018

Sci Rep

105

106

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Recurrent laryngeal nerve (RLN) injury is an intractable complication of thyroidectomy. Intraoperative nerve monitoring (IONM) was designed to prevent RLN injury. However, the results concerning the protective effect of IONM on RLN injury are still controversial. We searched all eligible databases from 1980 to 2017. Meta-analysis was performed to evaluate the effect of IONM on RLN injury. Sensitivity analysis was also conducted to check the stability of our results. There were 34 studies included in the analysis. Overall analysis found a significant decrease in total injury (RR = 0.68, 95%CI: 0.55 to 0.83), transient injury (RR = 0.71, 95%CI: 0.57 to 0.88), and permanent injury (RD = −0.0026, 95%CI: −0.0039 to −0.0012) with IONM. Subgroup analysis found IONM played a preventive role of total, transient and permanent injury in patients undergoing bilateral thyroidectomy. IONM also reduced the incidence of total and transient injury for malignancy cases. Operations with IONM were associated with fewer total and transient RLN injuries in operation volume < 300 NARs per year and fewer total and permanent RLN injuries in operation volume ≥ 300 NARs per year. The application of IONM could reduce the RLN injury of thyroidectomy. Particularly, we recommend routine IONM for use in bilateral operations and malignancy operations.

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“…Lombardi et al . gave a negative conclusion about the protective effects of IONM on permanent injury 18 . Wong et al .…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Protective Effects of Intraoperative Nerve Monitoring (IONM) for Recurrent Laryngeal Nerve Injury in Thyroidectomy: Meta-analysis

Bai

Chen

2018

Sci Rep

105

106

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“…However, the critical controversy surrounding the application of IONM pertains to whether it really is useful for reducing the RLN palsy rate. Two recent systematic meta‐analyses comparing surgery conducted with and without IONM suggested no statistically significant benefit of IONM compared to visualization alone towards the outcomes of overall, transient or permanent RLN palsy when analysed per nerve at risk during thyroid surgery . In contrast, another meta‐analysis demonstrated the merits of IONM in preventing transient palsy during thyroidectomy, but found no advantage with regard to permanent palsy .…”

Section: Discussionmentioning

confidence: 99%

A meta‐analysis of intraoperative neuromonitoring of recurrent laryngeal nerve palsy during thyroid reoperations

Sun

Liu

Zhang

et al. 2017

Clinical Endocrinology

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“…az intraoperatív idegmonitorozás) bevezetése érdemben nem csökkentette a nervus laryngeus inferior területén végzett műtétek (leggyakrabban pajzsmirigyműtét) következtében kialakuló nervus recurrens sérülések gyakoriságát. Arányaiban azonban megnőtt a reverzibilisnek tartható bénulások száma [37][38][39]. Emiatt sok szerző még napjainkban is minimum 6 hónapos várakozási időt javasol a definitív hangréstágító műtét előtt (akár az életminőséget jelentősen rontó ideiglenes tracheotomiával) a spontán reinnerváció lehetősége miatt [40].…”

Section: ö Ss Zef O G L Al ó K ö Z L Em éNyunclassified

A laryngealis electromyographia szerepe a hangszalag-mozgászavarok diagnosztikájában és az alkalmazott kezelés kiválasztásában

et al. 2018

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The development of the therapeutic possibilities of vocal cord immobility necessitated the parallel renewal of diagnostic methods. In the last years, laryngeal electromyography, which was first introduced more than 70 years ago, has been re-discovered. After reviewing the international literature and their own experience, the authors present the indications, technical requirements, method and, particularly, the evaluation of the results of this procedure. Laryngeal electromyography makes the differentiation between mechanical fixation and immobility with neurological origin of the vocal folds possible. In case of laryngeal paralysis/paresis it also evaluates objectively the severity of neural injury, the prognosis of the disease and the necessity of any glottis-widening procedure. The widespread application of dynamic rehabilitation interventions is not conceivable without the routine application of laryngeal electromyography, so this sensitive diagnostic tool has to be introduced in all laryngological centers. Orv Hetil. 2018; 159(8): 303-311.

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“The final countdown”: Is intraoperative, intermittent neuromonitoring really useful in preventing permanent nerve palsy? Evidence from a meta-analysis

Cited by 55 publications

References 37 publications

Protective Effects of Intraoperative Nerve Monitoring (IONM) for Recurrent Laryngeal Nerve Injury in Thyroidectomy: Meta-analysis

Protective Effects of Intraoperative Nerve Monitoring (IONM) for Recurrent Laryngeal Nerve Injury in Thyroidectomy: Meta-analysis

A meta‐analysis of intraoperative neuromonitoring of recurrent laryngeal nerve palsy during thyroid reoperations

A laryngealis electromyographia szerepe a hangszalag-mozgászavarok diagnosztikájában és az alkalmazott kezelés kiválasztásában

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