Abstract
Objective: To compare the accuracy of neuro stimulation with laryngeal palpation (NSLP) and intraoperative neuro monitoring (CIONM) in total thyroidectomy with regards to injury to the recurrent laryngeal nerve.
Methods: A retrospective historical cohort study was carried out during the period between January 2014 and january 2018 in King Abdul Aziz Medical, Jeddah. A total of 260 cases that underwent total thyroidectomy were evaluated for recurrent laryngeal nerve injury. The injury rate in these cases was compared between cases done with continuous intraoperative nerve monitoring (group 1; n = 115) and those performed using neuro stimulation with laryngeal palpation (group 2; n = 145).
Results: There was no significant difference in nerve injury between the case done with intraoperative nerve monitoring and those with neuro stimulation with laryngeal palpation (p = 0.25). The presence or absence of laryngeal twitch (LT) (P < 0.001) and the acoustic response to electrical stimulation (P = 0.03) were significantly associated with nerve function at the end of the surgery.
Conclusion: Our results indicate that NSLP is a safe and reliable intraoperative method of RLN monitoring. Moreover our data confirm that IONM is not significantly better than NSLP reduce the rate of permanent PLNI. in rhyroid surgery.