갑상선 및 부갑상선 수술 중 신경 모니터링에 대한 가이드라인과 표준 술식

Gudelines and standards for intraoperative neuromonitoring in thyroid and parathyroid surgeries

The benefits of intraoperative neuromonitoring (IONM) extend beyond merely reducing the incidence of vocal cord paralysis. Although widely used, a review of various literatures and clinical studies indicates diverse applications of nerve monitoring. To advance and standardize IONM techniques, the International Neural Monitoring Study Group (INMSG) has published guidelines for monitoring the recurrent laryngeal nerve (RLN) and the external branch of the superior laryngeal nerve (EBSLN). While IONM effectively preserves RLN function, application methods vary among surgeons. Implementing standardized setups and guidelines can reduce vocal cord paralysis and facilitate appropriate decisions when loss of signal (LOS) occurs, thereby ensuring the best outcomes for patients. This review aims to synthesize the current INMSG guidelines and summarize standard procedures for RLN monitoring.