Advantages of intraoperative nerve monitoring in endoscopic thyroidectomy for papillary thyroid carcinoma.

Abstract

BACKGROUND This study aimed to evaluate the feasibility and effectiveness of intraoperative nerve monitoring (IONM) for reducing the recurrent laryngeal nerve (RLN) injury risk during central compartment lymph node dissection in endoscopic thyroidectomy of papillary thyroid carcinoma (PTC). METHODS The prospective cohort consisted of 69 patients diagnosed with PTC undergoing endoscopic thyroidectomy via the areola approach with (n=42) or without IONM (n=27). Multiple logistic regression models were used to assess the association between IONM and postoperative temporary vocal cord palsy or number of retrieved lymph nodes. RESULTS IONM was a protective factor against temporary RLN injury. IONM use was positively correlated with number of retrieved lymph nodes (β=1.563, P=0.003). After adjustment for operation type, the result remained significant (β=1.581, P<0.001). CONCLUSIONS IONM use reduced the risk of temporary vocal cord palsy and increased the number of retrieved lymph nodes in endoscopic thyroidectomy via the areola approach for patients with PTC.