Thyroidectomy is a pivotal surgical intervention for managing malignant thyroid conditions and selected benign diseases that cause significant symptoms. However, the procedure is associated with complications, including injuries to the recurrent laryngeal nerve (RLN) and the external branch of the superior laryngeal nerve (EBSLN), which can result in vocal cord paralysis and severely impact patient outcomes and quality of life. Intraoperative neuromonitoring (IONM) has emerged as a valuable technique to mitigate these risks by enabling precise nerve mapping, identification of anatomical variations, and functional assessment of critical nerves. This study comprehensively reviews the principles and methodologies of IONM in thyroidectomy, highlighting its utility in RLN and EBSLN preservation through standardized protocols. Furthermore, it examines recent advancements in monitoring technologies, including the application of needle and transcutaneous electrodes and the integration of the laryngeal adductor reflex. Despite the increasing adoption of IONM, challenges such as variability in implementation, cost, and limited accessibility persist. Continued research and technological refinement are essential to enhance the efficacy and accessibility of IONM and further improve surgical outcomes in thyroidectomy.
Da-Sol Kim (Mon,) studied this question.
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