{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T01:14:47Z","timestamp":1775610887216,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,4,18]],"date-time":"2016-04-18T00:00:00Z","timestamp":1460937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2017,10]]},"abstract":"Background<\/jats:title>The use of routine intraoperative neuromonitoring (IONM<\/jats:styled-content>) is controversial in thyroid surgery. Guidelines have been published to standardize IONM<\/jats:styled-content>. This study examines the impact of routine IONM<\/jats:styled-content> on a high\u2010volume thyroid surgeon.<\/jats:p><\/jats:sec>Methods<\/jats:title>A prospective study was conducted using IONM<\/jats:styled-content> between May 2013 and December 2014. Demographics, type of operation, pathology, recurrent laryngeal nerve (RLN<\/jats:styled-content>) and external branch of the superior laryngeal nerve (EBSLN<\/jats:styled-content>) visualization and sub\u2010type classification, cricothyroid or cricopharyngeal twitch\/electrode depolarization were obtained, and complications were recorded. Outcomes were compared with 500 thyroidectomies performed by the same surgeon without neuromonitoring.<\/jats:p><\/jats:sec>Results<\/jats:title>Two hundred and ninety\u2010nine total thyroidectomies and 191 hemithyroidectomies were performed with IONM<\/jats:styled-content> resulting in 789 RLN<\/jats:styled-content> and 789 EBSLN<\/jats:styled-content> at risk of injury. Demographics, indication, pathology and complications were similar between the two groups. IONM<\/jats:styled-content> provided additional information for 58 RLN<\/jats:styled-content> dissections (7.4%) stratifying surgical decision\u2010making. Loss of signal was detected in 1.8% of nerves at risk. IONM<\/jats:styled-content> assisted in identification of 109 (13.8%, P<\/jats:italic> < 0.0001) EBSLN<\/jats:styled-content>, including a 15.8% improvement in identifying type 2b EBSLN<\/jats:styled-content>. Utility of IONM<\/jats:styled-content> was not predicted by surgery indication; however, multinodular goitre was a significant predictor of IONM<\/jats:styled-content> assisted identification of type 2b EBSLN<\/jats:styled-content> (OR<\/jats:styled-content> = 2.24, P<\/jats:italic> = 0.01).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Routine IONM<\/jats:styled-content> provides intraoperative information to a high\u2010volume thyroid surgeon regarding the recurrent and external nerves over and above direct visualization alone, and its utility could not be predicted by operative indication.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.13606","type":"journal-article","created":{"date-parts":[[2016,4,19]],"date-time":"2016-04-19T02:30:57Z","timestamp":1461033057000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Prospective evaluation of the utility of routine neuromonitoring for an established thyroid surgical practice"],"prefix":"10.1111","volume":"87","author":[{"given":"Jane","family":"Lee","sequence":"first","affiliation":[{"name":"The University of Sydney Endocrine Surgery Unit Royal North Shore Hospital St Leonards New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheila","family":"Fraser","sequence":"additional","affiliation":[{"name":"The University of Sydney Endocrine Surgery Unit Royal North Shore Hospital St Leonards New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Glover","sequence":"additional","affiliation":[{"name":"The University of Sydney Endocrine Surgery Unit Royal North Shore Hospital St Leonards New South Wales Australia"},{"name":"Sydney Medical School Northern, Royal North Shore Hospital The University of Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stan","family":"Sidhu","sequence":"additional","affiliation":[{"name":"The University of Sydney Endocrine Surgery Unit Royal North Shore Hospital St Leonards New South Wales Australia"},{"name":"Sydney Medical School Northern, Royal North Shore Hospital The University of Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,4,18]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"96","article-title":"Total thyroidectomy: the technique of capsular dissection","volume":"62","author":"Delbridge L","year":"1992","journal-title":"ANZ J. 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