{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T14:19:59Z","timestamp":1788358799346,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,10,1]],"date-time":"2013-10-01T00:00:00Z","timestamp":1380585600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The prevalence of recurrent laryngeal nerve (RLN) injury is higher in repeat than in primary thyroid operations. The use of intraoperative nerve monitoring (IONM) as an aid in dissection of the scar tissue is believed to minimize the risk of nerve injury. The aim of this study was to examine whether the use of IONM in thyroid reoperations can reduce the prevalence of RLN injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study of patients who underwent thyroid reoperations with IONM versus with RLN visualization, but without IONM. The database of thyroid surgery was searched for eligible patients (treated in the years 1993\u20132012). The primary outcomes were transient and permanent RLN injury. Laryngoscopy was used to evaluate and follow RLN injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study group comprised 854 patients (139\u00a0men, 715 women) operated for recurrent goiter (<jats:italic>n<\/jats:italic> = 576), recurrent hyperthyroidism (<jats:italic>n<\/jats:italic> = 36), completion thyroidectomy for cancer (<jats:italic>n<\/jats:italic> = 194) or recurrent thyroid cancer (<jats:italic>n<\/jats:italic> = 48), including 472 bilateral and 382 unilateral reoperations; 1,326\u00a0nerves at risk (NAR). A group of 306 patients (500\u00a0NAR) underwent reoperations with IONM and 548 patients (826\u00a0NAR) had reoperations with RLN visualization, but without IONM. Transient and permanent RLN injuries were found respectively in 13 (2.6 %) and seven (1.4 %) nerves with IONM versus 52 (6.3 %) and 20 (2.4 %) nerves without IONM (<jats:italic>p<\/jats:italic> = 0.003 and <jats:italic>p<\/jats:italic> = 0.202, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>IONM decreased the incidence of transient RLN paresis in repeat thyroid operations compared with nerve visualization alone. The prevalence of permanent RLN injury tended to be lower in thyroid reoperations with IONM, but statistical validation of the observed differences requires a sample size of 920\u00a0NAR per arm.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-013-2260-x","type":"journal-article","created":{"date-parts":[[2013,10,1]],"date-time":"2013-10-01T01:11:26Z","timestamp":1380589886000},"page":"599-606","source":"Crossref","is-referenced-by-count":137,"title":["Intraoperative Nerve Monitoring Can Reduce Prevalence of Recurrent Laryngeal Nerve Injury in Thyroid Reoperations: Results of a Retrospective Cohort Study"],"prefix":"10.1002","volume":"38","author":[{"given":"Marcin","family":"Barczy\u0144ski","sequence":"first","affiliation":[{"name":"Department of Endocrine Surgery, Third Chair of General Surgery Jagiellonian University Medical College 37 Pr\u0105dnicka Street 31\u2010202 Krak\u00f3w Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksander","family":"Konturek","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Third Chair of General Surgery Jagiellonian University Medical College 37 Pr\u0105dnicka Street 31\u2010202 Krak\u00f3w Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"Pragacz","sequence":"additional","affiliation":[{"name":"Department of General Surgery Public Health Care Medical Center 78 11 Listopada Street 28\u2010200 Stasz\u00f3w Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Papier","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Third Chair of General Surgery Jagiellonian University Medical College 37 Pr\u0105dnicka Street 31\u2010202 Krak\u00f3w Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u0142gorzata","family":"Stopa","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Third Chair of General Surgery Jagiellonian University Medical College 37 Pr\u0105dnicka Street 31\u2010202 Krak\u00f3w Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojciech","family":"Nowak","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Third Chair of General Surgery Jagiellonian University Medical College 37 Pr\u0105dnicka Street 31\u2010202 Krak\u00f3w Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,10]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01655417"},{"key":"e_1_2_6_3_2","first-page":"604","volume":"111","author":"Levin KE","year":"1992","journal-title":"Reoperative thyroid surgery. 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