• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

甲状腺手术中的术中神经监测：喉返神经识别及手术时间分析

Intraoperative nerve monitoring in thyroid surgery: Analysis of recurrent laryngeal nerve identification and operative time.

作者信息

Maneeprasopchoke Prachya, Chongkolwatana Cheerasook, Pongsapich Warut, Iwata Ayaka J, Kamani Dipti, Randolph Gregory W

机构信息

Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand.

Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology Massachusetts Eye and Ear Infirmary, Harvard Medical School Boston Massachusetts USA.

出版信息

Laryngoscope Investig Otolaryngol. 2021 Feb 26;6(2):354-361. doi: 10.1002/lio2.543. eCollection 2021 Apr.

DOI:10.1002/lio2.543
PMID:33869769
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8035947/
Abstract

OBJECTIVE

To evaluate the clinical value of intraoperative nerve monitoring (IONM) by comparing the procedure times for thyroidectomies performed with and without IONM.

METHODS

A prospective, randomized, controlled study was conducted on 32 patients (representing 41 nerves at risk) undergoing thyroidectomies carried out by two experienced head and neck surgeons (CC & WP). Sixteen thyroidectomies were performed without IONM (the "non-IONM group"), while 16 thyroidectomies were performed with IONM (the "IONM group"). The measured datapoints were setup time, time to visual identification of the recurrent laryngeal nerve (RLN), time to confirm the RLN electrophysiologically, dissection time, and total operative time.

RESULTS

With both surgeons, the IONM group had shorter visual times to RLN identification than the non-IONM group (CC: 3.7 minutes vs 5.3 minutes; WP: 3.4 minutes vs 9.7 minutes). Additionally, the electrophysiological identification time for the IONM group was shorter than the visual identification time for the non-IONM group. The setup times, dissection times, and total operative times of the 2 groups did not significantly differ ( > .05). No RLN injuries were observed.

CONCLUSIONS

IONM reduces the time needed for RLN identification in thyroidectomies. Functional RLN confirmation can reassure surgeons of the operative results. Moreover, use of IONM does not significantly impact setup and total operative times.

LEVEL OF EVIDENCE

摘要

目的

通过比较有或没有术中神经监测（IONM）的甲状腺切除术的手术时间，评估术中神经监测的临床价值。

方法

对32例患者（共41条有风险的神经）进行了一项前瞻性、随机对照研究，这些患者接受了由两位经验丰富的头颈外科医生（CC和WP）实施的甲状腺切除术。16例甲状腺切除术未使用IONM（“非IONM组”），而16例甲状腺切除术使用了IONM（“IONM组”）。测量的数据点包括设置时间、肉眼识别喉返神经（RLN）的时间、通过电生理确认RLN的时间、解剖时间和总手术时间。

结果

两位外科医生实施手术时，IONM组肉眼识别RLN的时间均短于非IONM组（CC：3.7分钟对5.3分钟；WP：3.4分钟对9.7分钟）。此外，IONM组的电生理识别时间短于非IONM组的肉眼识别时间。两组的设置时间、解剖时间和总手术时间无显著差异（P>0.05）。未观察到RLN损伤。

结论

IONM可减少甲状腺切除术中识别RLN所需的时间。通过电生理确认RLN功能可让外科医生对手术结果放心。此外，使用IONM对设置时间和总手术时间无显著影响。

证据级别

2级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09c3/8035947/bf3b3c207bbb/LIO2-6-354-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09c3/8035947/8ed4b77105ce/LIO2-6-354-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09c3/8035947/bf3b3c207bbb/LIO2-6-354-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09c3/8035947/8ed4b77105ce/LIO2-6-354-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09c3/8035947/bf3b3c207bbb/LIO2-6-354-g001.jpg

相似文献

1
Intraoperative nerve monitoring in thyroid surgery: Analysis of recurrent laryngeal nerve identification and operative time.甲状腺手术中的术中神经监测：喉返神经识别及手术时间分析
Laryngoscope Investig Otolaryngol. 2021 Feb 26;6(2):354-361. doi: 10.1002/lio2.543. eCollection 2021 Apr.
2
Experience with intraoperative neuromonitoring of the recurrent laryngeal nerve improves surgical skills and outcomes of non-monitored thyroidectomy.喉返神经术中神经监测的经验可提高未进行监测的甲状腺切除术的手术技巧和手术效果。
Langenbecks Arch Surg. 2017 Jun;402(4):709-717. doi: 10.1007/s00423-016-1449-5. Epub 2016 May 21.
3
The value of intraoperative nerve monitoring against recurrent laryngeal nerve injury in thyroid reoperations.甲状腺再次手术中术中神经监测对喉返神经损伤的价值。
Medicine (Baltimore). 2021 Dec 23;100(51):e28233. doi: 10.1097/MD.0000000000028233.
4
Thyroid reoperation using intraoperative neuromonitoring.甲状腺再次手术中使用术中神经监测。
Endocrine. 2017 Dec;58(3):458-466. doi: 10.1007/s12020-017-1443-x. Epub 2017 Oct 19.
5
Systematic review with meta-analysis of studies comparing intraoperative neuromonitoring of recurrent laryngeal nerves versus visualization alone during thyroidectomy.系统评价和荟萃分析比较甲状腺切除术时喉返神经术中神经监测与单独可视化的研究。
J Surg Res. 2014 May 1;188(1):152-61. doi: 10.1016/j.jss.2013.12.022. Epub 2013 Dec 25.
6
Comparison of Recurrent Laryngeal Nerve Identification Time in the Lower Central Triangle during Thyroid Surgery Using Neurophysiological Mapping and Monitoring.神经生理定位与监测在甲状腺手术中下中央三角区喉返神经识别时间的比较
Medicina (Kaunas). 2021 Jul 24;57(8):748. doi: 10.3390/medicina57080748.
7
Intraoperative neuromonitoring versus visual nerve identification for prevention of recurrent laryngeal nerve injury in adults undergoing thyroid surgery.术中神经监测与视觉神经识别在预防成人甲状腺手术中喉返神经损伤的比较
Cochrane Database Syst Rev. 2019 Jan 19;1(1):CD012483. doi: 10.1002/14651858.CD012483.pub2.
8
Clinical value of intraoperative neuromonitoring of the recurrent laryngeal nerves in improving outcomes of surgery for well-differentiated thyroid cancer.喉返神经术中神经监测在改善高分化甲状腺癌手术结局中的临床价值
Pol Przegl Chir. 2011 Apr;83(4):196-203. doi: 10.2478/v10035-011-0030-8.
9
Prospective evaluation of the utility of routine neuromonitoring for an established thyroid surgical practice.对既定甲状腺手术实践中常规神经监测效用的前瞻性评估。
ANZ J Surg. 2017 Oct;87(10):E138-E142. doi: 10.1111/ans.13606. Epub 2016 Apr 18.
10
Association of Intraoperative Neuromonitoring With Reduced Recurrent Laryngeal Nerve Injury in Patients Undergoing Total Thyroidectomy.术中神经监测与甲状腺全切除术患者喉返神经损伤减少的相关性
JAMA Otolaryngol Head Neck Surg. 2016 Oct 1;142(10):994-1001. doi: 10.1001/jamaoto.2016.1954.

引用本文的文献

1
Enhancing recurrent laryngeal nerve localization during transoral endoscopic thyroid surgery using augmented reality: a proof-of-concept study.使用增强现实技术在经口内镜甲状腺手术中增强喉返神经定位：一项概念验证研究。
Ann Surg Treat Res. 2025 Mar;108(3):135-142. doi: 10.4174/astr.2025.108.3.135. Epub 2025 Feb 28.
2
Recurrent laryngeal never monitoring versus non-monitoring in parathyroid surgery.甲状旁腺手术中喉返神经的常规监测与非监测。
Front Endocrinol (Lausanne). 2023 Nov 28;14:1299943. doi: 10.3389/fendo.2023.1299943. eCollection 2023.
3
Intraoperative neuromonitoring of the recurrent laryngeal nerve is indispensable during complete endoscopic radical resection of thyroid cancer: A retrospective study.

本文引用的文献

1
Increased prevalence of neural monitoring during thyroidectomy: Global surgical survey.甲状腺切除术期间神经监测的患病率增加：全球手术调查。
Laryngoscope. 2020 Apr;130(4):1097-1104. doi: 10.1002/lary.28210. Epub 2019 Jul 30.
2
Learning Curve for Using Intraoperative Neural Monitoring Technology of Thyroid Cancer.甲状腺癌术中神经监测技术的学习曲线
Biomed Res Int. 2019 Feb 11;2019:8904736. doi: 10.1155/2019/8904736. eCollection 2019.
3
2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer.
甲状腺癌完全内镜根治性切除术中喉返神经的术中神经监测不可或缺：一项回顾性研究
Laryngoscope Investig Otolaryngol. 2022 Jul 14;7(4):1217-1223. doi: 10.1002/lio2.822. eCollection 2022 Aug.
4
Improving Voice Outcomes after Thyroid Surgery and Ultrasound-Guided Ablation Procedures.改善甲状腺手术及超声引导下消融术后的嗓音效果。
Front Surg. 2022 May 4;9:882594. doi: 10.3389/fsurg.2022.882594. eCollection 2022.
2015年美国甲状腺协会成人甲状腺结节和分化型甲状腺癌管理指南：美国甲状腺协会甲状腺结节和分化型甲状腺癌指南工作组
Thyroid. 2016 Jan;26(1):1-133. doi: 10.1089/thy.2015.0020.
4
Management of invasive well-differentiated thyroid cancer: an American Head and Neck Society consensus statement. AHNS consensus statement.侵袭性高分化甲状腺癌的管理：美国头颈学会共识声明。AHNS共识声明。
Head Neck. 2014 Oct;36(10):1379-90. doi: 10.1002/hed.23619. Epub 2014 Aug 23.
5
Systematic review with meta-analysis of studies comparing intraoperative neuromonitoring of recurrent laryngeal nerves versus visualization alone during thyroidectomy.系统评价和荟萃分析比较甲状腺切除术时喉返神经术中神经监测与单独可视化的研究。
J Surg Res. 2014 May 1;188(1):152-61. doi: 10.1016/j.jss.2013.12.022. Epub 2013 Dec 25.
6
Safety of neural monitoring in thyroid surgery.神经监测在甲状腺手术中的安全性。
Int J Surg. 2013;11 Suppl 1:S120-6. doi: 10.1016/S1743-9191(13)60031-X.
7
The long-term impact of routine intraoperative nerve monitoring during thyroid and parathyroid surgery.甲状腺和甲状旁腺手术中常规术中神经监测的长期影响。
Surgery. 2013 Oct;154(4):704-11; discussion 711-3. doi: 10.1016/j.surg.2013.06.039. Epub 2013 Sep 3.
8
Laryngeal nerve monitoring: current utilization among head and neck surgeons.喉返神经监测：头颈外科医生的当前应用。
Otolaryngol Head Neck Surg. 2012 Jun;146(6):895-9. doi: 10.1177/0194599812439278. Epub 2012 Mar 7.
9
Does extensive dissection of recurrent laryngeal nerve during thyroid operation increase the risk of nerve injury? Evidence from the application of intraoperative neuromonitoring.甲状腺手术中广泛解剖喉返神经是否会增加神经损伤的风险？术中神经监测应用的证据。
Am J Otolaryngol. 2011 Nov-Dec;32(6):499-503. doi: 10.1016/j.amjoto.2010.11.001. Epub 2011 Feb 8.
10
Intraoperative neuromonitoring for early localization and identification of recurrent laryngeal nerve during thyroid surgery.甲状腺手术中用于早期定位和识别喉返神经的术中神经监测。
Kaohsiung J Med Sci. 2010 Dec;26(12):633-9. doi: 10.1016/S1607-551X(10)70097-8.