{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T11:07:42Z","timestamp":1792062462253,"version":"4.4.0"},"reference-count":49,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,7,8]],"date-time":"2016-07-08T00:00:00Z","timestamp":1467936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The electrophysiologic responses of 1,381 recurrent laryngeal nerves (RLN) during monitored neck surgery were recorded and reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>With institutional review board approval, we reviewed thyroid and other neck surgeries performed with intraoperative nerve monitoring (IONM) between the years 1995 and 2006. This list yielded consecutively monitored 1,381 RLNs, with over 3,000 hours of monitoring experience. All patients underwent preoperative and postoperative laryngoscopy. In an initial subset of patients, both hook\u2010wire and endotracheal tube (ETT) surface electrodes were utilized. Normative stimulation parameters; postoperative vocal cord function prognostication using monitoring data; and false\u2010positive, false\u2010negative, and passive electrophysiologic responses were evaluated<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Hook\u2010wire electrodes and ETT surface electrodes were found to have good correlation in terms of amplitude (correlation coefficient, R = 0.89). Nerve stimulation of 1 to 2 mA resulted in an ipsilateral biphasic response, with 3.3 ms mean latency and 900 \u03bcV mean amplitude. Permanent and temporary RLN paralysis rates were 0% and 0.7%, respectively. Specificity of electromyography (EMG) loss of signal (LOS) postoperative vocal cord paralysis (VCP) detection was 99.9%, and sensitivity was 33%. Negative predictive value of EMG LOS at the end of surgery in the prediction of postoperative VCP was 99.6%, whereas its positive predictive value for VCP was 75%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Intraoperative nerve monitoring of the RLN during thyroid and other neck surgeries can aid in the nerve mapping, nerve identification, and prognostication of postoperative vocal cord function, which in turn can influence the surgeon's decision to proceed to bilateral surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 127:280\u2013286, 2017<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.26166","type":"journal-article","created":{"date-parts":[[2016,7,8]],"date-time":"2016-07-08T10:49:06Z","timestamp":1467974946000},"page":"280-286","source":"Crossref","is-referenced-by-count":85,"title":["Intraoperative electrophysiologic monitoring of the recurrent laryngeal nerve during thyroid and parathyroid surgery: Experience with 1,381 nerves at risk"],"prefix":"10.1002","volume":"127","author":[{"given":"Gregory W.","family":"Randolph","sequence":"first","affiliation":[{"name":"Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology Massachusetts Eye and Ear Infirmary and Harvard Medical School Boston Massachusetts U.S.A."},{"name":"Division of Surgical Oncology, Department of Surgery Massachusetts General Hospital and Harvard Medical School Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dipti","family":"Kamani","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology Massachusetts Eye and Ear Infirmary and Harvard Medical School Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,7,8]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"775","article-title":"Routine dissection and demonstration of the recurrent laryngeal nerve in subtotal thyroidectomy","volume":"66","author":"Lahey F","year":"1938","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2008.530"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814521381"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813487301"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812439278"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-008-9724-4"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.8831"},{"key":"e_1_2_7_9_1","unstructured":"MartiJ HolmT RandolphGW. 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