Unintended Consequences: Vagal Nerve Injury During Continuous Neuromonitoring in Thyroidectomy.
Vagus nerve injury during continuous neuromonitoring in thyroidectomy is rare and mostly transient.
Unintended Consequences: Vagal Nerve Injury During Continuous Neuromonitoring in Thyroidectomy.
To characterize the patterns, mechanisms, and outcomes of vagus nerve (vagus nerve) injury associated with continuous intraoperative neuromonitoring (continuous intraoperative neuromonitoring) during total thyroidectomy and to outline prevention strategies.
Retrospective identification of all postoperative vagus nerve injuries following total thyroidectomy with continuous intraoperative neuromonitoring.
Eight were transient and one permanent.
Most injuries (89%) arose during initial carotid sheath dissection or probe application, particularly in posterior vagus nerve positions or short, thick necks.
Older circumferential probes were more often involved.
All lesions were segmental with preserved recurrent laryngeal nerve electromyography.
Continuous intraoperative neuromonitoring-related vagus nerve injury rate is low (0.4%), and most cases recovered in approximately 4 months.
continuous intraoperative neuromonitoring-related vagus nerve injury is usually related to nerve exposure rather than probe handling.