Application of intraoperative neuromonitoring of recurrent laryngeal nerve during high-risk thyroid operation

OBJECTIVE:To investigate the efficacy of neuromonitoring recurrent laryngeal nerve during high-risk thyroid operation,in order to reduce the recurrent laryngeal nerve injury.METHODS:nerve monitoring were performed intraoperative for 150 cases of patients with complex thyroid operation,recorded vagus nerve and recurrent laryngeal nerve EMG before and after thyroidectomy and at the time of finding recurrent laryngeal nerve.The control group was 200 patients with out IONM before.RESULTS: RLN exploring mean time was(4.27±1.83) min.while in conventional operation(18.15±6.24) min(P0.05).Fifteen cases of the EMG signal decreased due to stretch,attract and other reasons.The measured values of V2 and R2 were slightly lower than that of V1 and R1 before the incision was sutured.Transient RLN pulse was 3.3% in 5 cases;control group was 5.5% in 11 cases,and permanent injury of RLN was in 6 cases(P0.05).CONCLUSION: In high-risk,complex thyroid surgery,the monitoring of recurrent laryngeal nerve can make the exposure of recurrent laryngeal nerve more precise and swiftly,hence reducing complications.