{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T09:01:23Z","timestamp":1781254883911,"version":"3.54.1"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Injuries of the recurrent laryngeal nerve (RLN) during thyroidectomy although infrequent can lead to major morbidity. Permanent RLN injury is uncommon; however, temporary neurapraxia and loss of signal (LOS) during intraoperative neuromonitoring (IONM) are seen more frequently. This study aimed to identify factors associated with type I (segmental) and II (global) LOS of the RLN during thyroid surgery and to analyze time to recovery of vocal cord function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This observational retrospective cohort study included 3806 patients (2924 female, 76.8% and 882 male, 23.2%) who underwent hemi or total thyroidectomy in a tertiary center between January 2015 and March 2021. Regression analyses determined factors associated with LOS. Postoperative fibreoptic laryngoscopy was used to measure time to recovery of vocal cord function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      RLN LOS occurred in 167 (2.7%) of 5983 nerves at risk during surgery. The rate of Type I and Type II LOS per nerve at risk was 1.4% and 1.3%, respectively. Compared with an indication of malignancy, toxic nodule was associated with 96% increased odds of LOS independent of age and sex (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Time to recovery was reduced for those with a Type II LOS (median 4\u00a0weeks) compared to Type I LOS (median 8\u00a0weeks and\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.04). Female sex and increasing age were independently associated with a longer duration to return of vocal cord function.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Time to recovery of RLN function is significantly reduced for patients with Type II LOS. Toxic thyroid nodules were associated with a higher risk of LOS, and female sex and age are significantly associated with a longer time to recovery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70254","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T15:25:21Z","timestamp":1771255521000},"page":"660-667","source":"Crossref","is-referenced-by-count":2,"title":["A Study of Time to Recovery Following Loss of Neuromonitoring Signal of the Recurrent Laryngeal Nerve in Thyroid Surgery"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3178-8982","authenticated-orcid":false,"given":"Joyce","family":"Yu","sequence":"first","affiliation":[{"name":"University of Sydney  Camperdown NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rathina","family":"Ragavan","sequence":"additional","affiliation":[{"name":"Macquarie University  Macquarie Park NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Nylen","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Aniss","sequence":"additional","affiliation":[{"name":"University of Sydney Endocrine Surgical Unit  St Leonards Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stan","family":"Sidhu","sequence":"additional","affiliation":[{"name":"University of Sydney Endocrine Surgical Unit  St Leonards Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Papachristos","sequence":"additional","affiliation":[{"name":"University of Sydney Endocrine Surgical Unit  St Leonards Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Novakovic","sequence":"additional","affiliation":[{"name":"University of Sydney Voice Lab  Camperdown NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Stewart","sequence":"additional","affiliation":[{"name":"University of Sydney Voice Lab  Camperdown NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7973-3773","authenticated-orcid":false,"given":"Karl","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Neurology and Clinical Neurophysiology Royal North Shore Hospital  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9316-0377","authenticated-orcid":false,"given":"Hakan","family":"Ozoran","sequence":"additional","affiliation":[{"name":"Clinical Medical School University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Sywak","sequence":"additional","affiliation":[{"name":"University of Sydney Endocrine Surgical Unit  St Leonards Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.16956\/jes.2017.17.3.89"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znaa081"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2021.10.013"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.05.003"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6417"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.12590"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.15536"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2019.0087"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.12980"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.21037\/gs.2017.07.15"},{"key":"e_1_2_13_12_1","doi-asserted-by":"crossref","unstructured":"RoncuniC. WatteG. ZettlerC. G.\u201cIntraoperative Neuromonitoring in Thyroidectomy: A Systematic Review and Meta\u2010Analysis of 10 260 Patients.\u201d2023 https:\/\/doi.org\/10.4322\/ahns.2023.0019.","DOI":"10.4322\/ahns.2023.0019"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2022.03.036"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012483.pub2"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2013.12.022"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010005\u20100355\u20108"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24175"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25807"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010019\u201005178\u20106"},{"key":"e_1_2_13_20_1","volume-title":"Noninvasive Management of Voice Disorders: An Umbrella Review","author":"Garabet R.","year":"2024"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70254","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/wjs.70254","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70254","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T08:55:01Z","timestamp":1781254501000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/wjs.70254"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,16]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1002\/wjs.70254"],"URL":"https:\/\/doi.org\/10.1002\/wjs.70254","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,16]]}}}