Netto Irene de Pedro, Vartanian Jose Guilherme, Ferraz Pablo Rodrigo Rocha, Salgado Priscila, Azevedo Juliana Bueno Meirelles de, Toledo Ronaldo Nunes, Testa José Ricardo Gurgel, Carrara-de-Angelis Elisabete, Kowalski Luiz Paulo
Head and Neck Surgery and Otorhinolaryngology Department, Hospital do Câncer A. C. Camargo, São Paulo, Brazil.
Sao Paulo Med J. 2007 May 3;125(3):186-90. doi: 10.1590/s1516-31802007000300011.
Intraoperative nerve monitoring has emerged as a valuable tool to facilitate recurrent laryngeal nerve identification during thyroid surgery, thereby avoiding its injury. The aim was to evaluate vocal fold mobility in patients who underwent thyroidectomy with intraoperative nerve monitoring.
Cohort formed by a consecutive series of patients, at a tertiary cancer hospital.
The subjects were patients who underwent thyroidectomy using intraoperative laryngeal nerve monitoring, between November 2003 and January 2006. Descriptive analysis of the results and comparison with a similar group of patients who did not undergo nerve monitoring were performed.
A total of 104 patients were studied. Total thyroidectomy was performed on 65 patients. Vocal fold immobility (total or partial) was detected in 12 patients (6.8% of the nerves at risk) at the first postoperative evaluation. Only six (3.4% of the nerves at risk) continued to present vocal fold immobility three months after surgery. Our previous series with 100 similar patients without intraoperative nerve monitoring revealed that 12 patients (7.5%) presented vocal fold immobility at the early examination, and just 5 (3.1%) maintained this immobility three months after surgery, without significant difference between the two series.
In this series, the use of intraoperative nerve monitoring did not decrease the rate of vocal fold immobility.
术中神经监测已成为甲状腺手术中辅助识别喉返神经的一项重要工具，从而避免其损伤。本研究旨在评估接受术中神经监测的甲状腺切除术患者的声带活动度。
在一家三级癌症医院，对一系列连续的患者组成的队列进行研究。
研究对象为2003年11月至2006年1月期间接受术中喉返神经监测的甲状腺切除术患者。对结果进行描述性分析，并与一组未接受神经监测的类似患者进行比较。
共研究了104例患者。65例患者接受了全甲状腺切除术。术后首次评估时，12例患者（占危险神经的6.8%）出现声带活动障碍（完全或部分）。术后三个月，仅有6例（占危险神经的3.4%）仍存在声带活动障碍。我们之前对100例未进行术中神经监测的类似患者的研究系列显示，12例患者（7.5%）在早期检查时出现声带活动障碍，术后三个月仅有5例（3.1%）仍存在这种活动障碍，两组之间无显著差异。
在本研究系列中，术中神经监测的使用并未降低声带活动障碍的发生率。
