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Gianlorenzo Dionigi,Vincenzo Bartolo,Antonio Giacomo Rizzo,Massimo Marullo,Valerio Fabiano,Antonina Catalfamo,Francesca Pia Pergolizzi,Antonino Cancellieri,Giuseppinella Melita 대한갑상선-내분비외과학회 2018 The Koreran journal of Endocrine Surgery Vol.18 No.1
Literature on intraoperative neuro monitoring (IONM) during endocrine surgery have increased over recent years. A comprehensive understanding of the role of IONM for prevention of nerve injuries is critical to maximize safety during surgery of the anterior compartment of the neck. Neuromonitoring techniques are currently considered safe technique and technology; however, albeit sporadically, have been reported some complications and related side effects using such methods. The complications described can be related to the electrodes positioned at the larynx, at the obstruction of the endotracheal tube, the drugs used for anesthesia and the effects of electrical stimulation on nerve structures and systemic levels. This review will explore the safety issues of IONM to improve the outcomes among patients undergoing monitored thyroidectomy.
It Sometimes Happens: Staging Surgery in Coexisting Graves' Disease and Thyroid Cancer
Ettore Caruso,Maria De Pasquale,Antonella Pino,Vincenzo Bartolo,Fausto Famà,Gianlorenzo Dionigi 대한갑상선-내분비외과학회 2019 The Koreran journal of Endocrine Surgery Vol.19 No.3
Thyroidectomy is a safe procedure often performed either for benign or malignant thyroid diseases. Complication rate is low and bilateral recurrent laryngeal nerve (RLN) injury associated with thyroidectomy is rarely described. The RLN may be injured bilaterally and damage is usually recognized postoperatively. With an increased use of intraoperative neural monitoring (IONM), an adaptation of the resection strategy appears to be necessary in case of an intraoperative loss of signal of the first operated side with total thyroidectomy planned. We review a case of a 21-year-old female with a history of Graves' disease who underwent a total thyroidectomy in a 2-stage procedure due to a loss of RLN function detected intraoperatively. The patient recovered uneventfully from the 2 surgeries.
Technical Instructions for Continuous Intraoperative Neural Monitoring in Thyroid Surgery
Hoon Yub Kim,Young Jun Chai,Marcin Barczynski,ozer Makay,Che-Wei Wu,Antonio Giacomo Rizzo,Vincenzo Bartolo,Hui Sun,Gianlorenzo Dionigi,the Korean Intraoperative Neural Monitoring Society (KINMoS) 대한갑상선-내분비외과학회 2018 The Koreran journal of Endocrine Surgery Vol.18 No.1
One of the most significant advancements in neural monitoring for thyroid surgery is currently the permanent recording of the vagus nerve (VN) in order to prevent intraoperatively recurrent laryngeal nerve (RLN) iatrogenic injuries. Continuous intraoperative neuromonitoring (CIONM) seems to be superior to intermitted intraoperative neural monitoring (I-IONM) because it enhances standardization, and it provides entire and constant RLN function surveillance as the surgeon dissects the thyroid gland. It also has to be highlighted that the surgical maneuvers for the CIONM probe placement must be accurate in order to avoid a potential iatrogenic morbidity on the VN function. With this review article the Korean Intraoperative Neural Monitoring Society (KINMoS) provides a comprehensive analyses of CIONM technique.