Highlights
- •Retrospective review of prospectively collected ACS-NSQIP Thyroidectomy database.
- •Of 6942 patients undergoing thyroidectomy, 4269 used intraoperative neuromonitoring.
- •Similar rate of overall nerve injury in intraoperative nerve monitor use and without.
- •Nerve monitoring was associated with decreased odds of severe nerve injury.
Abstract
Objective
Conflicting reports exist regarding the benefit of intraoperative neuromonitoring
(INM) for patients undergoing thyroidectomy. We hypothesized that in a national sample,
the risk of mild and severe RLNi is decreased for patients undergoing neoplasm-related
disease (NRD) thyroidectomy with INM compared to patients without INM.
Methods
The database was queried for patients that underwent total thyroidectomy for NRD with
and without INM. A multivariable logistic regression model was used to determine the
associated odds of RLNi.
Results
From 6942 patients, 4269 (61.5%) had INM during thyroidectomy. Patients with INM had
a similar rate of overall RLNi compared to patients without INM (5.7% vs. 6.6%, p = 0.118).
After adjusting for covariates, INM was associated with decreased odds of severe-RLNi
(OR 0.23, p = 0.036) but not mild-RLNi (p = 0.16).
Conclusion
INM is associated with a nearly 80% decreased associated odds of severe RLNi during
thyroidectomy for NRD. Future prospective confirmation is needed, and if confirmed,
patients undergoing thyroidectomy for NRD should have INM to reduce the risk of RLNi
and its associated morbidity.
Keywords
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Article info
Publication history
Published online: October 13, 2021
Accepted:
October 11,
2021
Received in revised form:
September 6,
2021
Received:
March 19,
2021
Footnotes
American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) and the hospitals participating in the ACS NSQIP are the source of the data used herein; they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors.
Identification
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