External branch of the superior laryngeal nerve monitoring during thyroid and parathyroid surgery: International Neural Monitoring Study Group standards guideline statement

Rocco Domenico Alfonso Bellantone, Celestino Pio Lombardi, Marcin Barczyński, Gregory W. Randolph, Claudio R. Cernea, Henning Dralle, Gianlorenzo Dionigi, Piero F. Alesina, Radu Mihai, Camille Finck, Davide Lombardi, Dana M. Hartl, Akira Miyauchi, Jonathan Serpell, Samuel Snyder, Erivelto Volpi, Gayle Woodson, Jean Louis Kraimps, Abdullah N. Hisham

Research output: Contribution to journalArticle

165 Citations (Scopus)

Abstract

Intraoperative neural monitoring (IONM) during thyroid surgery has gained widespread acceptance as an adjunct to the gold standard of visual identification of the recurrent laryngeal nerve (RLN). Contrary to routine dissection of the RLN, most surgeons tend to avoid rather than routinely expose and identify the external branch of the superior laryngeal nerve (EBSLN) during thyroidectomy or parathyroidectomy. IONM has the potential to be utilized for identification of the EBSLN and functional assessment of its integrity; therefore, IONM might contribute to voice preservation following thyroidectomy or parathyroidectomy. We reviewed the literature and the cumulative experience of the multidisciplinary International Neural Monitoring Study Group (INMSG) with IONM of the EBSLN. A systematic search of the MEDLINE database (from 1950 to the present) with predefined search terms (EBSLN, superior laryngeal nerve, stimulation, neuromonitoring, identification) was undertaken and supplemented by personal communication between members of the INMSG to identify relevant publications in the field. The hypothesis explored in this review is that the use of a standardized approach to the functional preservation of the EBSLN can be facilitated by application of IONM resulting in improved preservation of voice following thyroidectomy or parathyroidectomy. These guidelines are intended to improve the practice of neural monitoring of the EBSLN during thyroidectomy or parathyroidectomy and to optimize clinical utility of this technique based on available evidence and consensus of experts.
Original languageEnglish
Pages (from-to)S1-S1-14
JournalTHE LARYNGOSCOPE
Volume123 Suppl 4
DOIs
Publication statusPublished - 2013

Keywords

  • Electromyography
  • Humans
  • Laryngeal Muscles
  • Laryngeal Nerves
  • Monitoring, Intraoperative
  • Parathyroidectomy
  • Postoperative Complications
  • Superior laryngeal nerve
  • Thyroid Gland
  • Thyroidectomy
  • Vocal Cord Paralysis
  • Voice Disorders
  • external branch of the superior laryngeal nerve
  • nerve identification
  • nerve monitoring
  • nerve stimulation
  • thyroid and parathyroid surgery

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