Technical Instructions for Continuous Intraoperative Neural Monitoring in Thyroid Surgery

One of the most significant advancements in neural monitoring for thyroid surgery is currently the permanent recording of the vagus nerve (VN) in order to prevent intraoperatively recurrent laryngeal nerve (RLN) iatrogenic injuries. Continuous intraoperative neuromonitoring (CIONM) seems to be superior to intermitted intraoperative neural monitoring (I-IONM) because it enhances standardization, and it provides entire and constant RLN function surveillance as the surgeon dissects the thyroid gland. It also has to be highlighted that the surgical maneuvers for the CIONM probe placement must be accurate in order to avoid a potential iatrogenic morbidity on the VN function. With this review article the Korean Intraoperative Neural Monitoring Society (KINMoS) provides a comprehensive analyses of CIONM technique.