{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T04:18:04Z","timestamp":1783484284259,"version":"3.55.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2012,6,14]],"date-time":"2012-06-14T00:00:00Z","timestamp":1339632000000},"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":[[2012,7,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>This study aimed to assess current use of recurrent laryngeal nerve monitoring (RLNM) for bilateral thyroid surgery in Germany. It explored the willingness of surgeons to change strategy after loss of signal (LOS) on the first side of resection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Surgical departments in Germany equipped with nerve monitors were asked to complete a structured questionnaire, specifying the number of thyroidectomies done in 2010, and the frequencies of RLNM, vagal stimulation, and electromyographic (EMG) recording before and after thyroidectomy. They were also asked about the surgical plan for bilateral goitre after LOS on the first side of resection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Based on manufacturers' sales data, 1119 (89\u00b71 per cent) of 1256 surgical departments in Germany were equipped with nerve monitors in 2010. A total of 595 departments (53\u00b72 per cent), accounting for approximately 75 per cent of all thyroidectomies in Germany during that year, returned a completed questionnaire. RLNM was used in 91\u00b77\u201393\u00b75 per cent of thyroidectomies, with the addition of routine vagal stimulation in 49\u00b73 per cent before, and 73\u00b78 per cent after resection. EMG responses to vagal stimulation were recorded in 54\u00b78 per cent before, and 72\u00b75 per cent after resection. Some 93\u00b75 per cent of surgeons changed the resection plan for the other side in bilateral thyroid surgery after LOS had occurred on the first side.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>RLNM is now the standard of care during thyroidectomy in Germany. After LOS on the first side of resection in bilateral goitre, more than 90 per cent of respondents declared their willingness to change the resection plan for the contralateral side to avoid the risk of bilateral recurrent laryngeal nerve palsy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.8831","type":"journal-article","created":{"date-parts":[[2012,6,14]],"date-time":"2012-06-14T11:25:48Z","timestamp":1339673148000},"page":"1089-1095","source":"Crossref","is-referenced-by-count":121,"title":["Loss of the nerve monitoring signal during bilateral thyroid surgery"],"prefix":"10.1093","volume":"99","author":[{"given":"H","family":"Dralle","sequence":"first","affiliation":[{"name":"Department of General, Visceral and Vascular Surgery, Martin Luther University Halle-Wittenberg, Halle, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Sekulla","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Vascular 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