Endocrine Surgery Unit, Complejo Hospitalario de Navarra, Pamplona, Spain.
Nuclear Medicine Department. Complejo Hospitalario de Navarra, Pamplona, Spain.
Cir Esp (Engl Ed). 2023 Jul;101(7):466-471. doi: 10.1016/j.cireng.2022.06.050. Epub 2022 Jul 2.
The continuous intraoperative neuromonitoring (C-IONM) of the recurrent laryngeal nerve (RLN) could help reducing the incidence of nerve paralysis after thyroid surgery, in comparison with the mere anatomical visualization of the RLN. The objective is to assess the efficacy and utility of C-IONM as a predictive test for recurrent laryngeal nerve paralysis after thyroidectomy.
A prospective observational study was performed in 248 patients who underwent thyroid surgery where C-IONM was applied, between September 2018 and December 2019, in a high-volume center. A previous and later laryngoscopy was performed, which allowed to evaluate the reliability of the C-IONM as a predictive test for recurrent paralysis. Sensitivity (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPV) were studied.
A total number of 171 thyroidectomies, 62 hemithyroidectomies, 15 totalization thyroidectomies and 27 thyroidectomy with cervical dissections were performed. Postoperative laryngoscopy was altered in 40 patients (16.12%). The SE, SP, PPV and NPV values were 65%, 94.7%, 70.2% and 93.4% respectively.
C-IONM is a safe technique that provides real-time information about anatomical and functional integrity of the RLN and can improve the results of thyroid surgery.
与单纯解剖显露 RLN 相比，连续术中神经监测（C-IONM）可降低甲状腺手术后神经麻痹的发生率。本研究旨在评估 C-IONM 作为预测甲状腺切除术后 RLN 麻痹的有效性和实用性。
2018 年 9 月至 2019 年 12 月，在一家高容量中心，对 248 例行甲状腺手术且应用 C-IONM 的患者进行前瞻性观察研究。在该研究中，对患者进行了术前和术后喉镜检查，以评估 C-IONM 作为预测 RLN 麻痹的可靠性。本研究对 C-IONM 的敏感性（SE）、特异性（SP）、阳性预测值（PPV）和阴性预测值（NPV）进行了研究。
共进行了 171 例甲状腺切除术、62 例半甲状腺切除术、15 例全甲状腺切除术和 27 例甲状腺切除术加颈部清扫术。40 例患者术后喉镜检查结果发生改变（16.12%）。C-IONM 的 SE、SP、PPV 和 NPV 值分别为 65%、94.7%、70.2%和 93.4%。
C-IONM 是一种安全的技术，可实时提供 RLN 的解剖和功能完整性信息，并能改善甲状腺手术的结果。
