Department of Otolaryngology, Massachusetts Eye and Ear, Harvard Medical School Boston, Massachusetts, U.S.A.
Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, U.S.A.
Laryngoscope. 2020 Apr;130(4):1097-1104. doi: 10.1002/lary.28210. Epub 2019 Jul 30.
To investigate intraoperative nerve monitoring (IONM) use among thyroid surgeons.
A 25-question survey was used to assess attitudes regarding IONM use. Surveys were sent to surgeons registered to the American Academy of Otolaryngology-Head and Neck Surgery, International Association of Endocrine Surgeons, and American Head and Neck Society.
Among 1,015 respondents, 83% reported using IONM (65.1% always using IONM and 18.1% reporting selective use). For selective users, a majority reported using IONM for reoperative cases (95.1%) and in cases with preoperative vocal cord paralysis (59.8%). When comparing location, there was a significant difference in IONM implementation (P < 0.001), with 70.4% of North American responders using it ubiquitously compared to 27.4% of non-North American responders. Preoperative laryngeal exam was performed more universally by North American surgeons and more selectively by non-North American surgeons (P < 0.001). Other attitudes toward their implementation and the postoperative laryngeal exam were similar. Surgeons ≤45 years of age and those with ≤15 years of practice used IONM more than their peers (P < 0.001). Thyroid surgery volume, fellowship training, and type of practice had no bearing on IONM use.
The prevalence of IONM in thyroid and parathyroid surgeries has increased significantly over the past decade, with 83% of surgeons using IONM in some or all cases. Although IONM use may be more ubiquitous in North America, attitudes toward its implementation and pre- and postoperative laryngeal exams are fairly uniform. IONM use is more prevalent among younger surgeons, whereas its use has no correlation with thyroid surgery volume or type of practice.
4 Laryngoscope, 130:1097-1104, 2020.
调查甲状腺外科医生术中神经监测（IONM）的使用情况。
采用 25 个问题的调查问卷评估对 IONM 使用的态度。调查问卷发送给注册美国耳鼻喉科学会、国际内分泌外科医师协会和美国头颈学会的外科医生。
在 1015 名应答者中，83%报告使用 IONM（65.1%始终使用 IONM，18.1%报告选择性使用）。对于选择性使用者，大多数报告在复发性病例（95.1%）和术前声带麻痹病例（59.8%）中使用 IONM。在比较位置时，IONM 的实施情况存在显著差异（P < 0.001），与北美应答者相比，非北美应答者普遍使用 IONM 的比例为 70.4%，而非北美应答者的比例为 27.4%。北美外科医生更普遍地进行术前喉部检查，而非北美外科医生更选择性地进行术前喉部检查（P < 0.001）。对其实施和术后喉部检查的其他态度相似。≤45 岁的外科医生和实践经验≤15 年的外科医生比同龄人更常使用 IONM（P < 0.001）。甲状腺手术量、专科培训和实践类型对 IONM 的使用没有影响。
在过去十年中，IONM 在甲状腺和甲状旁腺手术中的应用明显增加，83%的外科医生在某些或所有病例中使用 IONM。尽管 IONM 的使用在北美可能更为普遍，但对其实施和术前及术后喉部检查的态度相当一致。IONM 的使用在年轻外科医生中更为普遍，而其使用与甲状腺手术量或实践类型无关。
4 级喉镜，130：1097-1104，2020。
