Various methods for intraoperative neural monitoring during thyroid surgery

Various methods for intraoperative neural monitoring during thyroid surgery

Intraoperative neural monitoring (IONM) during thyroidectomy is an essential technique to safeguard the recurrent laryngeal nerve (RLN) and the external branch of the superior laryngeal nerve (EBSLN), both critical for vocal cord function. Utilizing electromyography (EMG), IONM provides real-time feedback on nerve integrity, significantly reducing the risk of nerve damage during surgery. The primary methods of IONM include endotracheal tube electrodes, surface electrodes, needle electrodes, and continuous monitoring, each with distinct advantages and limitations. Endotracheal tube electrodes offer direct measurements but can be difficult to position, while surface electrodes are non-invasive but may experience signal interference. Needle electrodes provide precise measurements but are invasive, and continuous monitoring offers ongoing feedback but requires advanced equipment. The evolution of IONM began in the mid-20th century and has progressed significantly, leading to its widespread adoption in thyroid surgery by the mid-2000s. Enhanced by recent technological advancements and standardized by professional guidelines, IONM has become integral in reducing postoperative complications. Ongoing research aims to further refine IONM techniques, ensuring optimal patient outcomes and the preservation of nerve function in thyroid surgery.