Maisie Shindo1, Neil N Chheda. 1. Division of Otolaryngology-Head and Neck Surgery, School of Medicine, State University of New York at Stony Brook, NY 11794-8191, USA. mshindo@notes.cc.stonybrook.edu
Abstract
OBJECTIVE: To compare the incidence of postoperative vocal cord paresis or paralysis in a cohort of patients who underwent thyroidectomy with and without continuous recurrent laryngeal nerve (RLN) monitoring by a single senior surgeon. We hypothesize that continuous RLN monitoring reduces the rate of nerve injury during thyroidectomy DESIGN: Retrospective medical chart review. SETTING: Academic tertiary care medical center. PATIENTS: A total of 684 patients (1043 nerves at risk) who underwent thyroid surgery under general anesthesia. MAIN OUTCOME MEASURE: Incidence of vocal cord paresis or paralysis in patients who underwent thyroid surgery with continuous RLN monitoring vs those undergoing surgery without continuous RLN monitoring. RESULTS: The incidence of unexpected unilateral vocal cord paresis based on RLNs at risk was 2.09% (n = 14) in the monitored group and 2.96% (n = 11) in the unmonitored group. This difference was not statistically significant. The incidence of unexpected complete unilateral vocal cord paralysis was 1.6% in each group. Two of the 5 paralyses in the unmonitored group and 7 of the 11 paralyses in the monitored group had complete resolution. CONCLUSIONS: Monitoring of the RLN does not appear to reduce the incidence of postoperative temporary or permanent complete vocal cord paralysis. There appeared to be a slightly lower rate of postoperative paresis with RLN monitoring, but this difference was not statistically significant.
OBJECTIVE: To compare the incidence of postoperative vocal cord paresis or paralysis in a cohort of patients who underwent thyroidectomy with and without continuous recurrent laryngeal nerve (RLN) monitoring by a single senior surgeon. We hypothesize that continuous RLN monitoring reduces the rate of nerve injury during thyroidectomy DESIGN: Retrospective medical chart review. SETTING: Academic tertiary care medical center. PATIENTS: A total of 684 patients (1043 nerves at risk) who underwent thyroid surgery under general anesthesia. MAIN OUTCOME MEASURE: Incidence of vocal cord paresis or paralysis in patients who underwent thyroid surgery with continuous RLN monitoring vs those undergoing surgery without continuous RLN monitoring. RESULTS: The incidence of unexpected unilateral vocal cord paresis based on RLNs at risk was 2.09% (n = 14) in the monitored group and 2.96% (n = 11) in the unmonitored group. This difference was not statistically significant. The incidence of unexpected complete unilateral vocal cord paralysis was 1.6% in each group. Two of the 5 paralyses in the unmonitored group and 7 of the 11 paralyses in the monitored group had complete resolution. CONCLUSIONS: Monitoring of the RLN does not appear to reduce the incidence of postoperative temporary or permanent complete vocal cord paralysis. There appeared to be a slightly lower rate of postoperative paresis with RLN monitoring, but this difference was not statistically significant.
Authors: A Bergenfelz; S Jansson; A Kristoffersson; H Mårtensson; E Reihnér; G Wallin; I Lausen Journal: Langenbecks Arch Surg Date: 2008-07-17 Impact factor: 3.445