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Intraoperative nerve monitoring is associated with a lower risk of recurrent laryngeal nerve injury: A national analysis of 17,610 patients.
- Source :
-
American journal of surgery [Am J Surg] 2021 Feb; Vol. 221 (2), pp. 472-477. Date of Electronic Publication: 2020 Oct 16. - Publication Year :
- 2021
-
Abstract
- Background: Based on current evidence, the benefit of intraoperative nerve monitoring (IONM) in thyroid surgery is equivocal.<br />Methods: All patients who underwent planned thyroid surgery in the 2016-2018 ACS NSQIP procedure-targeted thyroidectomy dataset were included. Multivariable regression analyses were performed to examine the association between nerve monitoring and recurrent laryngeal nerve (RLN) injury while adjusting for patient demographics, extent of surgery, and perioperative variables.<br />Results: In total, 17,610 patients met inclusion criteria: 77.8% were female, and the median age was 52 years. IONM was used in 63.9% of cases. Of the entire cohort, 6.1% experienced RLN injury. Cases with IONM use had a lower rate of RLN injury compared to those that did not use IONM (5.7% vs. 6.8%, p = 0.0001). After adjustment, IONM was associated with reduced risk of RLN injury (OR 0.69, 95% CI 0.59-0.82, p < 0.0001).<br />Conclusions: Nationally, IONM is used in nearly two thirds of thyroid surgeries. IONM is associated with a lower risk of recurrent laryngeal nerve injury.<br />Competing Interests: Declaration of competing interest Julie A. Sosa is a member of the Data Monitoring Committee of the Medullary Thyroid Cancer Consortium Registry supported by GlaxoSmithKline, Novo Nordisk, AstraZeneca and Eli Lilly. She receives institutional research funding from Exelixis and Eli Lilly.<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Datasets as Topic
Female
Humans
Incidence
Intraoperative Complications etiology
Intraoperative Complications prevention & control
Male
Middle Aged
Recurrent Laryngeal Nerve
Recurrent Laryngeal Nerve Injuries etiology
Recurrent Laryngeal Nerve Injuries prevention & control
Retrospective Studies
Risk Assessment statistics & numerical data
Thyroid Gland innervation
Thyroid Gland surgery
United States epidemiology
Intraoperative Complications epidemiology
Monitoring, Intraoperative methods
Recurrent Laryngeal Nerve Injuries epidemiology
Thyroidectomy adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1883
- Volume :
- 221
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- American journal of surgery
- Publication Type :
- Academic Journal
- Accession number :
- 33121660
- Full Text :
- https://doi.org/10.1016/j.amjsurg.2020.10.013