[Neurostimulation of the recurrent laryngeal nerve--a routine method in thyroid gland surgery?].

INTRODUCTION

Thyroid operations belong to the most frequent procedures in Germany (100,000/year). An important quality parameter is the incidence of postoperative recurrent nerve paralysis. Intraoperative identification by visualization of the nerve with a paralysis rate of 1% is the present gold standard in dedicated centers.

PROBLEM: Can this results be further improved by use of an intraoperative neuromonitoring system (NM).

RESULTS

The use of NM is helpful in difficult situations (recurrent goiter, advanced carcinoma, anatomic variants), but a quality improvement is not yet proven.

CONCLUSION

NM can not replace the current nerve identification by meticulous preparation of anatomic structures. It should be used at the discretion of the operative surgeon.