Improving Safety of Neural Monitoring in Thyroid Surgery: Educational Considerations in Learning New Procedure

Literature on intraoperative neuro monitoring (IONM) during endocrine surgery have increased over recent years. A comprehensive understanding of the role of IONM for prevention of nerve injuries is critical to maximize safety during surgery of the anterior compartment of the neck. Neuromonitoring techniques are currently considered safe technique and technology; however, albeit sporadically, have been reported some complications and related side effects using such methods. The complications described can be related to the electrodes positioned at the larynx, at the obstruction of the endotracheal tube, the drugs used for anesthesia and the effects of electrical stimulation on nerve structures and systemic levels. This review will explore the safety issues of IONM to improve the outcomes among patients undergoing monitored thyroidectomy.