Intraoperative Neuromonitoring in Thyroid Surgery
Abstract
The purpose of the work is to estimate the efficiency of intraoperative neuromonitoring used as a means for preventing damage to the recurrent laryngeal nerve in thyroid surgery. The basis for the work is the analysis of surgical treatment in 120 patients with various diseases of a thyroid gland, of whom 60 patients being operated using intraoperative neuromonitoring. The surgical neuromonitor ”Neurosun 400”was used for the purpose of monitoring (”INOMED”, Germany). The main objectives of intraoperative neuromonitoring were the emergency detection and localization of a nerve, its exact differentiation from the surrounding tissues by means of a stimulator. Intraoperative neuromonitoring of a recurrent laryngeal nerve by means of the Neyrosan-400 device has considerably reduced time of searching the nerve. So, the time of search was averaged 9.2±0.8 min. in the control group, whereas in the main group – 3.1±0.7 min. (р <0.05). As a result, the general time of operation has decreased. The general duration of operation in the control group of patients was averaged 63.7±6.1 min., in the main group – 45.4±5.8 min. (р <0.05). The obligatory visualization is necessary for reliable prevention of damage to a recurrent laryngeal nerve during operation. The recurrent laryngeal nerve has an accurate minimum threshold of stimulation which is - 0.5ma, no matter what the patient’s age is. Using neuromonitoring in thyroid surgery with the Neyrosan-400 device allows both conducting emergency and accurate identification of a recurrent laryngeal nerve in all cases as well as avoiding traumatic damage.
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