Method for preventing and predicting recurrent laryngeal nerve injuries accompanying thyroid operations

Purpose. To study the results of surgical treatment of patients with thyroid disorders using neuromonitoring, which allows to reduce the incidence of recurrent laryngeal nerve injuries during surgical interventions.Materials and methods. The data of 198 patients who underwent surgery on the thyroid gland for benign thyroid disease were retrospectively analyzed. The mean age of the surgically operated patients was 48±17 y.o., including 38 (19.2%) men and 160 (80.8%) women. The patients were divided into two groups of 98 and 100 patients. The patients of the first group underwent surgical intervention using IOM, and the patients of the second group - without it.Results. In the postoperative period of the first group, transient paralysis developed in 5 (5.1%) patients and permanent paralysis - in 1 (1.0%) patient. The duration of visualization and nerve isolation in the surgical site was 6.11±0.5 min. The total time of the surgery was 74.8±3.1 minutes. In the second group, transient paralysis developed in 10 (10%) patients and permanent paralysis developed in 3 (3%) patients in the postoperative period. The duration of visualization and nerve isolation in the surgical site was 12.7±1.9 min. The total time of the surgery was 86.11±4.0 minutes. The differences between the groups in incidence rate of transient and permanent paralysis were statistically significant (p = 0.01; p = 0.001).Conclusion. Intraoperative monitoring of the recurrent laryngeal nerve during various surgical interventions on the thyroid gland is a safe and highly effective method allowing reduce the incidence of complications and surgery duration.