{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:38:52Z","timestamp":1787503132988,"version":"build-2736575974"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Continuous intraoperative nerve stimulation (IONM) with uninterrupted monitoring is likely better than intermittent IONM in preventing vocal cord palsy after thyroid surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a comparative study of intermittent versus continuous IONM in patients with benign and malignant thyroid disease treated at a tertiary centre over 10\u2009years. Early postoperative and permanent vocal cord palsy rates were estimated. Multivariable logistic regression analysis was used to quantify the contributions of clinical and histopathological variables to early postoperative and permanent vocal cord palsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 6029 patients were included, of whom 3139 underwent continuous and 2890 intermittent IONM. Based on nerves at risk (5208 versus 5024 nerves), continuous IONM had a 1\u00b77-fold lower early postoperative vocal cord palsy rate than intermittent monitoring (1\u00b75 versus 2\u00b75 per cent). This translated into a 30-fold lower permanent vocal cord palsy rate (0\u00b702 versus 0\u00b76 per cent). In multivariable logistic regression analysis, continuous IONM independently reduced early postoperative vocal cord palsy 1\u00b78-fold (odds ratio (OR) 0\u00b756) and permanent vocal cord palsy 29\u00b74-fold (OR 0\u00b7034) compared with intermittent IONM. One permanent vocal cord palsy per 75\u00b70 early vocal cord palsies was observed with continuous IONM, compared with one per 4\u00b72 after intermittent IONM. Early postoperative vocal cord palsies were 17\u00b79-fold less likely to become permanent with continuous than intermittent IONM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Continuous IONM is superior to intermittent IONM in preventing vocal cord palsy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bjs.11901","type":"journal-article","created":{"date-parts":[[2020,8,8]],"date-time":"2020-08-08T06:16:41Z","timestamp":1596867401000},"page":"566-573","source":"Crossref","is-referenced-by-count":74,"title":["Superiority of continuous over intermittent intraoperative nerve monitoring in preventing vocal cord palsy"],"prefix":"10.1093","volume":"108","author":[{"given":"R","family":"Schneider","sequence":"first","affiliation":[{"name":"Department of Visceral, Vascular and Endocrine Surgery, University Hospital, Martin Luther University Halle-Wittenberg, Halle (Saale) , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6796-079X","authenticated-orcid":false,"given":"A","family":"Machens","sequence":"additional","affiliation":[{"name":"Department of Visceral, Vascular and Endocrine Surgery, University Hospital, Martin Luther University Halle-Wittenberg, Halle (Saale) , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Sekulla","sequence":"additional","affiliation":[{"name":"Department of Visceral, Vascular and Endocrine Surgery, University Hospital, Martin Luther University Halle-Wittenberg, Halle (Saale) , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Lorenz","sequence":"additional","affiliation":[{"name":"Department of Visceral, Vascular and Endocrine Surgery, University Hospital, Martin Luther University Halle-Wittenberg, Halle (Saale) , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Elwerr","sequence":"additional","affiliation":[{"name":"Department of Visceral, Vascular and Endocrine Surgery, University Hospital, Martin Luther University Halle-Wittenberg, Halle (Saale) , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Dralle","sequence":"additional","affiliation":[{"name":"Department of Visceral, Vascular and Endocrine Surgery, University Hospital, Martin Luther University Halle-Wittenberg, Halle (Saale) , Germany"},{"name":"Department of General, Visceral and Transplantation Surgery, Section of Endocrine Surgery, University of Duisburg-Essen, Essen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,5,26]]},"reference":[{"key":"2023063010535586300_znaa177-bib1","first-page":"254","article-title":"About extirpation of goitre and its consequences","volume":"29","author":"Kocher","year":"1883","journal-title":"Langenbecks Arch Klin Chir Ver Dtsch Z Chir"},{"key":"2023063010535586300_znaa177-bib2","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s00423-010-0615-4","article-title":"European endocrine surgery in the 150-year history of Langenbeck's Archives of Surgery","volume":"395","author":"Dralle","year":"2010","journal-title":"Langenbecks Arch Surg"},{"key":"2023063010535586300_znaa177-bib3","doi-asserted-by":"crossref","first-page":"e21","DOI":"10.1097\/SLA.0000000000003580","article-title":"The American Association of Endocrine Surgeons Guidelines for the definitive surgical management of thyroid disease in adults","volume":"271","author":"Patel","year":"2020","journal-title":"Ann Surg"},{"key":"2023063010535586300_znaa177-bib4","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1002\/lary.28210","article-title":"Increased prevalence of neural monitoring during thyroidectomy: global surgical survey","volume":"130","author":"Feng","year":"2020","journal-title":"Laryngoscope"},{"key":"2023063010535586300_znaa177-bib5","doi-asserted-by":"crossref","DOI":"10.1002\/hed.26093","article-title":"Intraoperative nerve monitoring is used routinely by a significant majority of head and neck surgeons in thyroid surgery and impacts on extent of surgery\u00a0\u2013\u00a0survey of the American Head and Neck Society","author":"Ritter","year":"2020","journal-title":"Head Neck"},{"key":"2023063010535586300_znaa177-bib6","doi-asserted-by":"crossref","first-page":"477","DOI":"10.3390\/jcm8040477","article-title":"StuDoQ\/Thyroid Study Group. 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