{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T13:17:30Z","timestamp":1783775850716,"version":"3.55.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2015,9,2]],"date-time":"2015-09-02T00:00:00Z","timestamp":1441152000000},"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":[[2015,9,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Continuous monitoring of electromyographic (EMG) amplitudes of the vocal muscles detects impending injury of the recurrent laryngeal nerve (RLN) during thyroid operations earlier than intermittent EMG monitoring. This may alert the surgeon to stop a manoeuvre causing stretching or pressure on the RLN, with better recovery of nerve function.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients with intact preoperative RLN function who underwent thyroid surgery for benign disease between January 2011 and September 2014 under continuous intraoperative nerve monitoring (CIONM) or intermittent intraoperative nerve monitoring (IIONM) were included in this observational study conducted at a tertiary surgical centre. For CIONM, combined EMG events indicative of imminent nerve injury were defined as an EMG amplitude decrease of 50 per cent or more and a latency increase of 10 per cent relative to baseline values. The rates of early and permanent palsy for the two groups of patients were compared.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 1526 patients, 788 of whom (1314 nerves at risk) underwent thyroid surgery using CIONM and 738 (965 nerves at risk) had IIONM. With the use of CIONM, 63 (82 per cent) of 77 combined events were reversible during the operation. No permanent vocal fold palsy occurred with CIONM, whereas four unilateral permanent vocal fold palsies (0\u00b74 per cent) were diagnosed after IIONM (P = 0\u00b7019).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Operation with CIONM resulted in fewer permanent vocal fold palsies compared with IIONM after thyroid surgery in patients with benign disease.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.9889","type":"journal-article","created":{"date-parts":[[2015,9,2]],"date-time":"2015-09-02T20:38:40Z","timestamp":1441226320000},"page":"1380-1387","source":"Crossref","is-referenced-by-count":111,"title":["Postoperative vocal fold palsy in patients undergoing thyroid surgery with continuous or intermittent nerve monitoring"],"prefix":"10.1093","volume":"102","author":[{"given":"R","family":"Schneider","sequence":"first","affiliation":[{"name":"Department of General, Visceral and Vascular Surgery, Martin Luther University Halle-Wittenberg, Ernst-Grube-Strasse 40, D-06120, Halle (Saale), Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Sekulla","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Vascular Surgery, Martin Luther University Halle-Wittenberg, Ernst-Grube-Strasse 40, D-06120, Halle (Saale), Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Machens","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Vascular Surgery, Martin Luther University Halle-Wittenberg, Ernst-Grube-Strasse 40, D-06120, Halle (Saale), Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Lorenz","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Vascular Surgery, Martin Luther University Halle-Wittenberg, Ernst-Grube-Strasse 40, D-06120, Halle (Saale), Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Nguyen Thanh","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Vascular Surgery, Martin Luther University Halle-Wittenberg, Ernst-Grube-Strasse 40, D-06120, Halle (Saale), Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Dralle","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Vascular Surgery, Martin Luther University Halle-Wittenberg, Ernst-Grube-Strasse 40, D-06120, Halle (Saale), Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2015,9,2]]},"reference":[{"key":"2021021715580651900_bjs9889-bib-0001","first-page":"775","article-title":"Routine dissection and demonstration of the recurrent laryngeal nerve in subtotal thyroidectomy","volume":"66","author":"Lahey","year":"1938","journal-title":"Surg Gynecol Obstet"},{"key":"2021021715580651900_bjs9889-bib-0002","first-page":"63","article-title":"Electrical stimulation of the human recurrent laryngeal nerve during thyroid operation","volume":"263","author":"Flisberg","year":"1969","journal-title":"Acta Otolaryngol Suppl"},{"key":"2021021715580651900_bjs9889-bib-0003","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/bjs.1800570102","article-title":"Thyroidectomy: prevention of bilateral recurrent nerve palsy. Results of identification of the nerve over 23 consecutive years (1946\u201369) with a description of an additional safety measure","volume":"57","author":"Riddell","year":"1970","journal-title":"Br J Surg"},{"key":"2021021715580651900_bjs9889-bib-0004","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1002\/lary.21119","article-title":"Electrophysiologic recurrent laryngeal nerve monitoring during thyroid and parathyroid surgery: international standards guideline statement","volume":"121","author":"Randolph","year":"2011","journal-title":"Laryngoscope"},{"key":"2021021715580651900_bjs9889-bib-0005","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1007\/s00268-005-0355-8","article-title":"Pitfalls of intraoperative nerve monitoring for predicting postoperative recurrent laryngeal nerve function during thyroidectomy","volume":"30","author":"Chan","year":"2001","journal-title":"World J Surg"},{"key":"2021021715580651900_bjs9889-bib-0006","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1097\/01.sla.0000132260.34503.02","article-title":"Nerve monitoring in thyroid surgery: prospective evaluation of intraoperative electrophysiological responses for the prediction of recurrent laryngeal nerve injury","volume":"240","author":"Hermann","year":"2004","journal-title":"Ann Surg"},{"key":"2021021715580651900_bjs9889-bib-0007","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1007\/s00268-008-9483-2","article-title":"Intraoperative monitoring of the recurrent laryngeal nerve in thyroid surgery","volume":"32","author":"Dralle","year":"2008","journal-title":"World J Surg"},{"key":"2021021715580651900_bjs9889-bib-0008","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1016\/j.surg.2013.06.039","article-title":"The long-term impact of routine intraoperative nerve monitoring during thyroid and parathyroid surgery","volume":"154","author":"Snyder","year":"2013","journal-title":"Surgery"},{"key":"2021021715580651900_bjs9889-bib-0009","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1111\/ans.12590","article-title":"Consensus statement on intra-operative electrophysiological recurrent laryngeal nerve monitoring during thyroid surgery","volume":"84","author":"Serpell","year":"2014","journal-title":"ANZ J Surg"},{"key":"2021021715580651900_bjs9889-bib-0010","doi-asserted-by":"crossref","first-page":"3026","DOI":"10.1002\/lary.24195","article-title":"Intraoperative monitoring: normative range associated with normal postoperative glottic function","volume":"123","author":"Caragacianu","year":"2013","journal-title":"Laryngoscope"},{"key":"2021021715580651900_bjs9889-bib-0011","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1002\/bjs.8831","article-title":"Loss of the nerve monitoring signal during bilateral thyroid surgery","volume":"99","author":"Dralle","year":"2012","journal-title":"Br J Surg"},{"key":"2021021715580651900_bjs9889-bib-0012","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1089\/thy.2013.0004","article-title":"Staged thyroidectomy: time to consider intraoperative nerve monitoring a standard of care","volume":"23","author":"Dionigi","year":"2013","journal-title":"Thyroid"},{"key":"2021021715580651900_bjs9889-bib-0013","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/j.oraloncology.2013.03.438","article-title":"Management of laryngeal nerves and parathyroid glands at thyroidectomy","volume":"49","author":"Darr","year":"2013","journal-title":"Oral Oncol"},{"key":"2021021715580651900_bjs9889-bib-0014","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1007\/s00104-014-2751-9","article-title":"Surgical strategy during intended total thyroidectomy after loss of EMG signal on the first side of resection","volume":"86","author":"Schneider","year":"2015","journal-title":"Chirurg"},{"key":"2021021715580651900_bjs9889-bib-0015","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1007\/s00423-009-0503-y","article-title":"A new anchor electrode design for continuous nerve monitoring of the recurrent laryngeal nerve by vagal nerve stimulations","volume":"394","author":"Schneider","year":"2009","journal-title":"Langenbecks Arch Surg"},{"key":"2021021715580651900_bjs9889-bib-0016","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.amjsurg.2009.04.036","article-title":"A new vagal anchor electrode for real-time monitoring of the recurrent laryngeal nerve","volume":"199","author":"Schneider","year":"2010","journal-title":"Am J Surg"},{"key":"2021021715580651900_bjs9889-bib-0017","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1002\/hed.21564","article-title":"Impact of continuous intraoperative nerve monitoring on autonomic nervous system during thyroid surgery","volume":"33","author":"Ulmer","year":"2011","journal-title":"Head Neck"},{"key":"2021021715580651900_bjs9889-bib-0018","doi-asserted-by":"crossref","first-page":"1979","DOI":"10.1002\/lary.23411","article-title":"Safety analysis of vagal nerve stimulation for continuous nerve monitoring during thyroid surgery","volume":"122","author":"Friedrich","year":"2012","journal-title":"Laryngoscope"},{"key":"2021021715580651900_bjs9889-bib-0019","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1002\/lary.24550","article-title":"Continuous vagal IONM prevents RLN paralysis by revealing initial EMG changes of impending neuropraxic injury: a prospective, multicenter study","volume":"124","author":"Phelan","year":"2014","journal-title":"Laryngoscope"},{"key":"2021021715580651900_bjs9889-bib-0020","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1002\/hed.23187","article-title":"Continuous intraoperative vagus nerve stimulation for identification of imminent recurrent laryngeal nerve injury","volume":"35","author":"Schneider","year":"2013","journal-title":"Head Neck"},{"key":"2021021715580651900_bjs9889-bib-0021","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1007\/s00423-009-0581-x","article-title":"Postoperative laryngoscopy in thyroid surgery: proper timing to detect recurrent laryngeal nerve injury","volume":"395","author":"Dionigi","year":"2010","journal-title":"Langenbecks Arch Surg"},{"key":"2021021715580651900_bjs9889-bib-0022","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1055\/s-2002-31982","article-title":"A critical estimation of intraoperative neuromonitoring (IONM) in thyroid surgery","volume":"127","author":"Hamelmann","year":"2002","journal-title":"Zentralbl Chir"},{"key":"2021021715580651900_bjs9889-bib-0023","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1007\/s00423-003-0444-9","article-title":"Validity of intra-operative neuromonitoring signals in thyroid surgery","volume":"389","author":"Thomusch","year":"2004","journal-title":"Langenbecks Arch Surg"},{"key":"2021021715580651900_bjs9889-bib-0024","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1007\/s00268-004-7226-6","article-title":"Evaluation of intraoperative recurrent nerve monitoring in thyroid surgery","volume":"28","author":"Beldi","year":"2004","journal-title":"World J Surg"},{"key":"2021021715580651900_bjs9889-bib-0025","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1016\/j.surg.2006.07.017","article-title":"The role of intraoperative nerve monitoring of recurrent laryngeal nerve during thyroidectomy: a comparative study on 1000 nerves at risk","volume":"140","author":"Chan","year":"2006","journal-title":"Surgery"},{"key":"2021021715580651900_bjs9889-bib-0026","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1007\/s00268-005-0351-z","article-title":"Sensitivity and specificity of intraoperative recurrent laryngeal nerve stimulation test for predicting vocal cord palsy after thyroid surgery","volume":"30","author":"Tomoda","year":"2006","journal-title":"World J Surg"},{"key":"2021021715580651900_bjs9889-bib-0027","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1002\/bjs.6417","article-title":"Randomized clinical trial of visualization versus nerve monitoring of recurrent laryngeal nerves during thyroidectomy","volume":"96","author":"Barczy\u0144ski","year":"2009","journal-title":"Br J Surg"},{"key":"2021021715580651900_bjs9889-bib-0028","doi-asserted-by":"crossref","first-page":"2597","DOI":"10.1007\/s00268-014-2591-2","article-title":"Postoperative vocal cord dysfunction despite normal intraoperative neuromonitoring: an unexpected complication with the risk of bilateral palsy","volume":"38","author":"Melin","year":"2014","journal-title":"World J Surg"},{"key":"2021021715580651900_bjs9889-bib-0029","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/1916-0216-43-16","article-title":"Identification alone versus intraoperative neuromonitoring of the recurrent laryngeal nerve during thyroid surgery: experience of 2034 consecutive patients","volume":"43","author":"Cal\u00f2","year":"2014","journal-title":"J Otolaryngol Head Neck Surg"},{"key":"2021021715580651900_bjs9889-bib-0030","doi-asserted-by":"crossref","first-page":"S140","DOI":"10.1016\/j.ijsu.2014.05.026","article-title":"Double probe intraoperative neuromonitoring with a standardized method in thyroid surgery","volume":"12","author":"De Falco","year":"2014","journal-title":"Int J Surg"},{"key":"2021021715580651900_bjs9889-bib-0031","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.1016\/j.surg.2004.07.018","article-title":"Risk factors of paralysis and functional outcome after recurrent laryngeal nerve monitoring in thyroid surgery","volume":"136","author":"Dralle","year":"2004","journal-title":"Surgery"}],"container-title":["British Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.9889","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/academic.oup.com\/bjs\/article-pdf\/102\/11\/1380\/36300433\/bjs9889.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/bjs\/article-pdf\/102\/11\/1380\/36300433\/bjs9889.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,20]],"date-time":"2021-05-20T14:13:40Z","timestamp":1621520020000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/102\/11\/1380-1387\/6136413"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,9,2]]},"references-count":31,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2015,9,2]]},"published-print":{"date-parts":[[2015,9,9]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.9889","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2015,10]]},"published":{"date-parts":[[2015,9,2]]}}}