Dionigi Gianlorenzo, Bacuzzi Alessandro, Boni Luigi, Rovera Francesca, Rausei Stefano, Frattini Francesco, Dionigi Renzo
Department of Surgical Sciences, University of Insubria, Varese-Como, Italy.
Surg Technol Int. 2010 Apr;19:25-37.
Recurrent laryngeal nerve (RLN) palsy during thyroidectomy is associated with multiple risk factors as patient- and surgeon-related bailiff. The risk is greater for thyroid cancer, Graves' disease, re-operation, and mediastinal goiter in less experienced centers and in patients in whom the RLN could not be identified during operation. Anatomical landmarks exist to identify RLN. Nevertheless, transient and permanent RLN injuries still exist. Intraoperative neuromonitoring (IONM) has been introduced to facilitate identification and verify functional integrity of the RLN in thyroid surgery. In this chapter, we present relevant medical literature and personal experience on thyroid surgery with IONM. Technical, medical, and legal aspects of monitoring are discussed.
甲状腺切除术中喉返神经（RLN）麻痹与多种风险因素相关，包括患者相关因素和外科医生相关因素。在经验不足的中心以及手术中无法识别RLN的患者中，甲状腺癌、格雷夫斯病、再次手术和纵隔甲状腺肿的风险更高。存在用于识别RLN的解剖标志。然而，RLN的短暂性和永久性损伤仍然存在。术中神经监测（IONM）已被引入以促进甲状腺手术中RLN的识别并验证其功能完整性。在本章中，我们介绍了有关IONM甲状腺手术的相关医学文献和个人经验。讨论了监测的技术、医学和法律方面。
