US residents experiences with intraoperative nerve monitoring in thyroid and parathyroid surgery

Abstract

Background Understanding the patterns of IONM use and training among resident otolaryngologists is essential to ensure that the IONM skills and knowledge gained in residency are optimized for successful future practice of IONM. Method An electronic survey was distributed to US‐based OHNS residents. Questions evaluated resident experience, implementation, knowledge and understanding of IONM for endocrine surgeries. Results One hundred and seven OHNS residents participated, spanning all training levels and US geographic locations. The majority of residents received no didactic teaching on IONM (74.5%) nor had a clear troubleshooting algorithm in the event of a loss of signal (69.8%). The majority of residents were uncertain regarding the advantages/disadvantages of continuous versus intermittent IONM. Conclusion The knowledge gap found in our survey study suggests that greater teaching of IONM principles for endocrine head and neck surgeries in OHNS residency programs would help to ensure successful utilization in future practice.

Intraoperative Neuromonitoring Does Not Reduce the Risk of Temporary and Definitive Recurrent Laryngeal Nerve Damage during Thyroid Surgery: A Systematic Review and Meta-Analysis of Endoscopic Findings from 73,325 Nerves at Risk

“…Nevertheless, our review does not cover specific complex scenarios (such as reinterventions) where IONM can play a decisive role, nor does it delve into the significance of these tools for training and teaching purposes. Defining these essential points of IONM usage is in our opinion extremely relevant, given the call for more information on this tool advocated by otolaryngology residents [35]. IONM remains a basic tool for thyroid surgery and further research might help define which scenarios are positively and significantly influenced by its use.…”

“…For what concerns procedure types, we found 27,561 thyroidectomies, 9719 hemithyroidectomies, 916 subtotal thyroidectomies, and 514 completion thyroidectomies (3305 procedures were not defined, although the articles provided enough data to allow for RLN rate quantification). The included articles included 35,192 open cervicotomy accesses, 3926 endoscopic accesses, and 1759 robotic procedures.…”