• Huang Kai, Lin Xixia, Long Miaoyun, Chen Qinchang, Peng Xinzhi, Luo Dingyuan, and Li Honghao.
• a Division of Vascular and Thyroid Surgery , Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University , Guangzhou , PR China.
• Acta Otolaryngol. 2017 Dec 1; 137 (12): 1275-1280.

ObjectiveThis research was aimed to investigate whether the intraoperative nerve monitoring (IONM) can reduce the incidence of recurrent laryngeal nerve (RLN) injury in geriatric patients undergoing thyroid surgery.MethodsThis retrospective cohort study included 522 geriatric patients undergoing thyroid surgery between January 2013 and June 2016 in the Sun Yat-sen Memorial Hospital. Patients with IONM during the surgery (n = 340) were compared with patients without IONM (n = 212). RLN injury was verified by direct or indirect laryngoscope and relative factors for injury would be retrospectively analyzed.ResultsThe use of IONM group showed significant reduction in both total and transient RLN injury incidence, when compared with that in control group (1.76 versus 4.72%, p = .01 and 1.32 versus 3.67%, p = .03, respectively). However, the permanent RLN injury incidence did not show difference between the two groups (p = .3).ConclusionsOur finding showed the use of IONM resulted in significantly reduction in RLN injury incidence. The technology of IONM is safe and convenient to detect, track and monitor the complete function of RLN and to provide the guidance for the surgeons during the thyroid surgery in geriatric patients, who are at high risk of RLN injury.

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