Laryngeal Nerve Monitoring: "no consensus exists"

http://www.ncbi.nlm.nih.gov/pubmed/22399282

Otolaryngol Head Neck Surg. 2012 Mar 7. [Epub ahead of print]

Laryngeal Nerve Monitoring: Current Utilization among Head and Neck Surgeons.

Singer MC, Rosenfeld RM, Sundaram K.

Source

Department of Otolaryngology-Head and Neck Surgery, Georgia Health Sciences University, Augusta, Georgia, USA.

Abstract

Objective. 

There is continued debate over the value of laryngeal nerve monitoring (LNM) during thyroidectomy. Previous studies have suggested that utilization of electromyographic endotracheal tubes for neuromonitoring is limited. We queried head and neck surgeons regarding their attitudes toward LNM.

Study Design. 

Voluntary survey.

Setting. 

Internet based.

Subjects and Methods. 

An anonymous survey of the members of the American Head and Neck Society was performed. Information was collected on participants' training history, practice setting, years of experience, and annual volume of thyroid and parathyroid surgeries. Participants' use of LNM and their beliefs regarding possible benefits were assessed.

Results. 

One hundred seventy surveys were completed (18% response rate). Of respondents, 65% use LNM in at least some thyroid and parathyroid cases, 37% always and 28% sometimes. The most commonly cited reasons for LNM use were "medical-legal protection" and "increased confidence." Comparing otolaryngologists to general surgeons, 43% versus 17% (P = .016) always use LNM, 27% versus 36% sometimes use monitoring, and 30% versus 47% never use monitoring. Younger surgeons were more likely to use LNM.

Conclusion. 

Currently, no consensus exists regarding the use of LNM during thyroid and parathyroid surgery. Our results suggest that LNM use has become more widespread. Irrespective of the reasons surgeons are adopting LNM, if this trend continues, LNM may eventually become routine practice among head and neck surgeons.