Piercosimo Nisi1, Giovanna Piva2, Federico Cozzani3, Matteo Rossini4, Elena Bonati5, Cristiana Madoni6, Elena Giovanna Bignami7, Paolo Del Rio8. 1. 1. Department of Medicine and Surgery, General Surgery Unit, Parma University Hospital. omento@hotmail.it. 2. Department of Medicine and Surgery, General Surgery Unit, Parma University Hospital. giovanna.piva@studenti.unipr.it. 3. General Surgery Unit, Parma University Hospital. federico.cozzani1@studenti.unipr.it. 4. 1. Department of Medicine and Surgery, General Surgery Unit, Parma University Hospital. matteo.rossini86@gmail.com. 5. 1. Department of Medicine and Surgery, General Surgery Unit, Parma University Hospital. ebonati86@gmail.com. 6. Department of Medicine and Surgery, Unit of Anesthesiology, Parma University Hospital. cmadoni@ao.pr.it. 7. Department of Medicine and Surgery, Unit of Anesthesiology, Parma University Hospital. elenagiovanna.bignami@unipr.it. 8. 1. Department of Medicine and Surgery, General Surgery Unit, Parma University Hospital. paolo.delrio@unipr.it.
Abstract
BACKGROUND: The injury of laryngeal recurrent nerve (RLN) is one of the most severe adverse event in thyroid surgery. The rate in literature is reported as 2-11% for transient palsy and 0,6-1,6% for permanent palsy (after 6 months from surgical procedure). METHODS: The patients undergoing thyroid surgery associated to Intraoperative Neuromonitoring (IONM were enrolled consecutively from 21/08/2014 to 30/08/2018. WE collected data from I-IONM and not by Continuos IONM (C-IONM) because we have interrupted C-IONM after a case of cardiac arrest (15TH patient) during the APS placement. RESULTS: The utility of the intraoperative neuro-monitoring system was evaluated with the following statistical methods:• Mann Withney U-test with independent samples, T-samples with coupled samples, Wilcoxon signed sign test, Chi square test., Positive predictive value (PPV), Negative predictive value (NPV),we considered the values for p <0.05 statistically positive. CONCLUSIONS: In high-volume centers the rate of transitory / permanent vocal cord palsy is low but also in these Units the need of feel safety is related to IONM. The use of the IONM is an helpful tool for dissection and anatomical identification of the nerves. IONM has a high specificity and sensitivity and a high negative predictive value. PPV as 52% definable low, may be related to the transient stupor of nerve function.
BACKGROUND: The injury of laryngeal recurrent nerve (RLN) is one of the most severe adverse event in thyroid surgery. The rate in literature is reported as 2-11% for transient palsy and 0,6-1,6% for permanent palsy (after 6 months from surgical procedure). METHODS: The patients undergoing thyroid surgery associated to Intraoperative Neuromonitoring (IONM were enrolled consecutively from 21/08/2014 to 30/08/2018. WE collected data from I-IONM and not by Continuos IONM (C-IONM) because we have interrupted C-IONM after a case of cardiac arrest (15TH patient) during the APS placement. RESULTS: The utility of the intraoperative neuro-monitoring system was evaluated with the following statistical methods:• Mann Withney U-test with independent samples, T-samples with coupled samples, Wilcoxon signed sign test, Chi square test., Positive predictive value (PPV), Negative predictive value (NPV),we considered the values for p <0.05 statistically positive. CONCLUSIONS: In high-volume centers the rate of transitory / permanent vocal cord palsy is low but also in these Units the need of feel safety is related to IONM. The use of the IONM is an helpful tool for dissection and anatomical identification of the nerves. IONM has a high specificity and sensitivity and a high negative predictive value. PPV as 52% definable low, may be related to the transient stupor of nerve function.
Authors: Paolo Del Rio; Piercosimo Nisi; Sara Benedicenti; Elisa Bertocchi; Enrico Luzietti; Mario Sianesi Journal: Ann Ital Chir Date: 2016 Impact factor: 0.766
Authors: Paolo Del Rio; Maria Francesca Arcuri; Paola Pisani; Belinda De Simone; Mario Sianesi Journal: Langenbecks Arch Surg Date: 2010-02-16 Impact factor: 3.445
Authors: Beata Wojtczak; Krzysztof Kaliszewski; Krzysztof Sutkowski; Marek Bolanowski; Marcin Barczyński Journal: Endocrine Date: 2017-11-08 Impact factor: 3.633