Koh, Yoon Woo1; Ban, Myung Jin1; Byeon, Hyung Kwon2; Kim, Da Hee2; Park, Jae Hong1
1 Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
2 Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea
Background: This study compares the association between the intraoperative loss of neuromonitoring signal (LOS) and the postoperative vocal cord function following retroauricular endoscopic or robotic thyroidectomy (RAT) versus conventional open thyroidectomy (COT).
Methods: A prospective case series study was performed. A total of 153 patients who received either RAT or COT from May 2014 to September 2015 were enrolled. The RAT and the COT groups consisted of 111 and 42 patients respectively. The international standardized evaluation of LOS using the NIM 3.0 system for the intraoperative neuromonitoring (IONM) of recurrent laryngeal nerves (RLNs) and the, pre- and postoperative vocal cord assessments using a flexible laryngoscope were used to analyze and determine the RLN at risk during thyroidectomy.
Results: The accuracy of IONM in predicting postoperative vocal cord function was 98.25% in our case series. The LOS rate, the early and permanent vocal cord palsy rates were compared between the two groups. The RAT group showed a trend towards a lower risk of postoperative RLN palsy when compared to the COT group, but no statistically significant difference was achieved.
Discussion & Conclusion: Similar risk of injury to RLN was found between the RAT and the COT based on our IONM data.