Laryngeal nerve monitoring and minimally invasive thyroid surgery: Complementary technologies

David J. Terris, Susan K. Anderson, Tammara L. Watts, Edward Chin

Research output: Contribution to journalArticle

49 Scopus citations

Abstract

Objective: To determine the feasibility of the combined use of laryngeal nerve monitoring and minimally invasive thyroid surgery. Design: Prospective, nonrandomized analysis of single-surgeon experience. Setting: Academic institution. Patients: Consecutive series of patients undergoing both minimally invasive thyroid surgery and laryngeal nerve monitoring. Main Outcome Measures: Incision length and incidence of temporary or permanent laryngeal nerve injury. Results: Two hundred eighty-three patients underwent thyroid surgery at the Medical College of Georgia, Augusta, between January 2004 and November 2006. Some type of minimal-access approach (endoscopic or nonendoscopic) was used in 137 cases (48.4%) in which general anesthesia was administered. Laryngeal nerve monitoring was performed in 73 (53.3%) of these 137 cases, although the proportion of cases in which it was performed increased significantly from 8.7% (2 of 23 cases) in 2004 to 95.2% (58 of 61 cases) in 2006 (P < .001). There were no cases of permanent nerve injury. The incidence of temporary recurrent laryngeal nerve paresis was 4.3% (4 of 92 nerves at risk) in the cases in which laryngeal nerve monitoring was used and 6.0% (5 of 84 nerves at risk) in the cases in which the nerve was visually identified without use of a monitor. This difference failed to reach statistical significance (P = .73), which may reflect an insufficient sample size. Conclusion: Monitoring of the laryngeal nerves is feasible in minimal-access thyroid surgery and may serve as a meaningful adjunct to the visual identification of nerves.

Original languageEnglish (US)
Pages (from-to)1254-1257
Number of pages4
JournalArchives of Otolaryngology - Head and Neck Surgery
Volume133
Issue number12
DOIs
StatePublished - Dec 1 2007

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ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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