Importance of incorporating intraoperative neuromonitoring of the external branch of the superior laryngeal nerve in thyroidectomy: A review and meta-analysis study

Mai Naytah; Iman Ibrahim; Sabrina da Silva

doi:10.1002/hed.25669

Importance of incorporating intraoperative neuromonitoring of the external branch of the superior laryngeal nerve in thyroidectomy: A review and meta-analysis study

Head Neck. 2019 Jun;41(6):2034-2041. doi: 10.1002/hed.25669. Epub 2019 Feb 1.

Authors

Mai Naytah^{1

2}, Iman Ibrahim^{1

3}, Sabrina da Silva⁴

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, Royal Victoria Hospital, McGill University, Montréal, Québec, Canada.
² Department of Otolaryngology-Head and Neck Surgery, King Fahd Hospital, Ministry of Health, Jeddah, Kingdom of Saudi Arabia.
³ Audio-vestibular Medicine Unit, Department of Otolaryngology-Head and Neck Surgery, Kasr AlAini Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt.
⁴ Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, McGill University, Montréal, Québec, Canada.

PMID: 30706616
DOI: 10.1002/hed.25669

Abstract

Background: Voice changes are frequently reported after thyroidectomy due to injury to the external branch of the superior laryngeal nerve (EBSLN) and paralysis of the cricothyroid muscle, The objective is to evaluate the advantage of intraoperative neuromonitoring (IONM) in identifying EBSLN during thyroid surgery.

Methods: Data sources were MEDLINE, PubMed, Web of Science, and Cochrane Library from January 1, 1995, through July 1, 2018. Published studies of adult patients who had thyroid surgery and an attempt to identify EBSLN done by conventional methods and/or IONM were selected.

Results: Seven studies met all inclusion criteria. Patients who had IONM during thyroid surgery had a significantly increased number of identified EBSLN at risk, compared to the control group.

Conclusion: The use of IONM during open thyroid surgery increases EBSLN identification/visualization, and hence it may decrease the incidence of post-thyroidectomy voice disorders.

Keywords: EBSLN; IONM; the cricothyroid muscle (CTM); thyroidectomy.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Humans
Intraoperative Neurophysiological Monitoring*
Laryngeal Nerves / physiopathology*
Postoperative Complications / etiology
Postoperative Complications / prevention & control*
Thyroidectomy / adverse effects*
Voice Disorders / etiology
Voice Disorders / prevention & control*