Effect of nerve monitorization on laryngeal nerve damage in secondary thyroid cancer surgery

Objective: Recurrent Laryngeal Nerve injury is an important complication that is rare but disruption of life quality when occurs. The aim of this prospective randomized study is to compare the results of intraoperative nerve monitoring (IOSM) and conventional visual nerve dissection (IOSM) during thyroidectomy. We also aimed that determine the effect of IONM on the postoperative recurrent laryngeal nerve palsy rate, duration of nerve finding and operation time, changes of postoperative serum calcium and Parathormone levels and presenting our own data to the literature as Çukurova University General Surgery Clinic. Materials and Methods: 527 patients were chosen and included to study between January 2012 and February 2017 from Çukurova University General surgery clinic. Patients randomized into two groups which are neuromonitorisation group (Group 1; n = 241) and no neuromonitorisation group (Group 2; n = 286). Patients' age, gender, postoperative pathology results, surgical procedures, preoperative and postoperative serum calcium and parathormone values, duration of nerve finding, duration of operation, temporary and permanent hoarseness were evaluated statistically. Results : There was no statistically significant difference between the groups with and without monitor using. There was a significant decrease in serum calcium and parathormone levels before and after the operation but there was no significant difference between the groups. In terms of duration of nerve finding and operation time significantly lower in the monitor used group. Conclusion: The use of the IOSM has been shown to speed up the nerve finding phase and thus shorten the duration of the operation. Although not statistically significant, it contributed positively to the prevention of nerve damage. Keywords: Recurrent Laryngeal Nerve, Neuromonitorisation, Thyroidectomy Complication.