반회후두신경을 침범한 갑상선 유두암 환자에서 수술 중 신경감시의 적용

Application of intraoperative neuromonitoring in patients with papillary thyroid carcinoma involving the recurrent laryngeal nerve

Intraoperative neuromonitoring (IONM) has been widely applied for thyroidectomy in patients with papillary thyroid carcinoma (PTC) to identify and preserve the recurrent laryngeal nerve (RLN). Moreover, IONM may be helpful to predict the postoperative function of the vocal fold and provide rationales to decide the extent of surgery, including staged operation. However, the usefulness of IONM in patients with PTC involving the RLN has not been well introduced. Invasion of the PTC to the RLN may have lesser impact on survival of the patient compared to that to the trachea or esophagus. Therefore, preservation or resection of a functioning nerve involved by cancer may be a controversial issue. In this article, usefulness of IONM in patients with PTC involving the RLN will be reviewed based on recent related studies and guidelines.