Abstract:

Objective To analyze the clinical effect of recurrent laryngeal nerve (RLN) exposure in unilateral thyroid surgery with or without intraoperative neural monitoring(IONM).Method The clinical data of 66 patients who received the unilateral thyroid surgery in Shunde Hospital of Southern Medical University from January 2019 to November 2020 were retrospectively reviewed and analyzed. The application of IONM served as the categorization basis of two groups, with 33 cases in each group. In the group without nerve monitoring, the recurrent laryngeal nerve was directly exposed by blunt dissection, while in the group with IONM, the RLN was gradually exposed under the guidance of IONM. Then the amount of bleeding, the incidence of RLN injury, the length of stay and medical expenses of the two groups were compared and analyzed. Result There was no significant difference in the amount of bleeding and length of stay between the two groups (P ＞ 0.05). The rate of temporary RLN injury in the group with IONM was lower than that in another group without IONM, but there was no significant difference (P ＞ 0.05). The medical expenses in the group with IONM were significantly higher than that in another group without IONM (P ＜ 0.05). Conclusion Whether the intraoperative neural monitoring is adopted or not, the operation safety and efficacy in the unilateral thyroid surgery is consistent in exposing the recurrent laryngeal nerve. However, the application of nerve monitoring entails a higher cost but helps to reduce the incidence of RLN injury to a certain extent. 

Key words: Exposure of recurrent laryngeal nerve, Injury of recurrent laryngeal nerve, Intraoperative neural monitoring