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Trends in intraoperative neural monitoring for thyroid and parathyroid surgery amongst otolaryngologists and general surgeons

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Abstract

The role of intraoperative neural monitoring (IONM) in thyroid and parathyroid surgery remains a controversial subject for surgeons regardless of surgical training and background. This study aims to compare usage patterns and motivations behind IONM among otolaryngologist-head and neck surgeons (OTO-HNS) and general surgeons (GS) performing thyroid and parathyroid surgery. The study is a multi-institution survey of 103 otolaryngology and affiliated 103 GS programs in the US. 206 surveys were sent to OTO-HNS and GS academic program directors with a response rate of 44.7 %. Of those who performed thyroid surgery, 80.6 % of OTO-HNS and 48.0 % of GS surgeons reported using IONM. 44.3 % of OTO-HNS and 30.8 % of GS respondents used IONM in all thyroid cases. For thyroid surgery, as surgical volume increased, surgeons were more likely to use IONM more frequently. Fourteen percent (14 %) of the OTO-HNS and 41.7 % of the GS respondents used IONM primarily to locate the RLN. Forty percent (40 %) of the OTO-HNS and 8.3 % of the GS used IONM for medicolegal reasons. The majority of OTO-HNS programs use IONM for thyroid and parathyroid surgery, whereas less than half of GS programs regularly use IONM for these surgeries. Thyroid surgeons, with larger thyroid surgery volume, regardless of discipline, tend to use IONM more. The motivations for using IONM differ significantly between OTO-HNS and general surgeons in that more GS use it for locating the RLN, and more OTO-HNS use it for continuous monitoring of the nerve during resection and for medicolegal purposes.

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References

  1. Johnson S, Goldenberg D (2008) Intraoperative monitoring of the recurrent laryngeal nerve during revision thyroid surgery. Otolaryngol Clin North Am 41(6):1147–1154

    Article  PubMed  Google Scholar 

  2. Barczyński M, Konturek A, Cichón S (2009) Randomized clinical trial of visualization versus neuromonitoring of recurrent laryngeal nerves during thyroidectomy. Br J Surg 96(3):240–246

    Article  PubMed  Google Scholar 

  3. Thomusch O, Sekulla C, Walls G, Machens A, Dralle H (2002) Intraoperative neuromonitoring of surgery for benign goiter. Am J Surg 183(6):673–678

    Article  PubMed  Google Scholar 

  4. Robertson ML, Steward DL, Gluckman JL, Welge J (2004) Continuous laryngeal nerve integrity monitoring during thyroidectomy: does it reduce risk of injury? Otolaryngol Head Neck Surg 131(5):596–600

    Article  PubMed  Google Scholar 

  5. Shindo M, Chheda NN (2007) Incidence of vocal cord paralysis with and without recurrent laryngeal nerve monitoring during thyroidectomy. Arch Otolaryngol Head Neck Surg 133(5):481–485

    Article  PubMed  Google Scholar 

  6. Sturgeon C, Sturgeon T, Angelos P (2009) Neuromonitoring in thyroid surgery: attitudes, usage patterns, and predictors of use among endocrine surgeons. World J Surg 33(3):417–425

    Article  PubMed  Google Scholar 

  7. Horne SK, Gal TJ, Brennan JA (2007) Prevalence and patterns of intraoperative nerve monitoring for thyroidectomy. Otolaryngol Head Neck Surg 136(6):952–956

    Article  PubMed  Google Scholar 

  8. Flisberg K, Lindholm T (1969) Electrical stimulation of the human recurrent laryngeal nerve during thyroid operation. Acta Otolaryngol Suppl 263:63–67

    PubMed  CAS  Google Scholar 

  9. Randolph GW, Dralle H, International Intraoperative Monitoring Study Group, Abdullah H, Barczynski M, Bellantone R, Brauckhoff M, Carnaille B, Cherenko S, Chiang FY, Dionigi G, Finck C, Hartl D, Kamani D, Lorenz K, Miccolli P, Mihai R, Miyauchi A, Orloff L, Perrier N, Poveda MD, Romanchishen A, Serpell J, Sitges-Serra A, Sloan T, Van Slycke S, Snyder S, Takami H, Volpi E, Woodson G (2011) Electrophysiologic recurrent laryngeal nerve monitoring during thyroid and parathyroid surgery: international standards guideline statement. Laryngoscope 121(Suppl 1):S1–S16

    Article  PubMed  Google Scholar 

  10. Dionigi G, Bacuzzi A, Barczynski M, Biondi A, Boni L, Chiang FY, Dralle H, Randolph GW, Rausei S, Sacco R, Sitges-Serra A (2011) Implementation of systematic neuromonitoring training for thyroid surgery. Updates Surg 63(3):201–207

    Article  PubMed  CAS  Google Scholar 

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, 17033, USA

    Yan Ho, Michele M. Carr & David Goldenberg

  2. Division of Otolaryngology-Head and Neck Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, H091, Hershey, PA, 17033, USA

    Yan Ho & David Goldenberg

  3. Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA

    Yan Ho

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  1. Yan Ho
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  2. Michele M. Carr
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  3. David Goldenberg
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Correspondence to David Goldenberg.

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Ho, Y., Carr, M.M. & Goldenberg, D. Trends in intraoperative neural monitoring for thyroid and parathyroid surgery amongst otolaryngologists and general surgeons. Eur Arch Otorhinolaryngol 270, 2525–2530 (2013). https://doi.org/10.1007/s00405-013-2359-6

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  • DOI: https://doi.org/10.1007/s00405-013-2359-6

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