{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T05:38:35Z","timestamp":1778218715943,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,10,8]],"date-time":"2019-10-08T00:00:00Z","timestamp":1570492800000},"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":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare continuous (C\u2010IONM) vs intermittent intraoperative neuromonitoring (I\u2010IONM) in complex benign thyroid surgery, and to follow up patients with loss of signal (LOS) or unilateral vocal fold paralysis (UVFP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective clinical study, prospective case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>University hospital and academic teaching hospital of Charit\u00e9\u2014University Medicine Berlin, Germany.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>C\u2010IONM\u2010 and I\u2010IONM\u2010assisted thyroid surgery was conducted in 357 patients diagnosed with recurrent goitre, Graves\u2019 disease, complex hyperparathyroidism, cervical preoperation (anterior access) and LOS in primary operation (2\u2010stage thyroidectomy).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>To evaluate the incidence of early postoperative and permanent UVFP, and to report the results of phonosurgical therapy in patients suffering from persisting dysphonia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 346 patients enrolled (81.8% female, 18.2% male) with 613 nerves at risk (NAR) being monitored (409 I\u2010IONM vs 204 C\u2010IONM), early postoperative UVFP was observed in 10.5% of I\u2010IONM vs 4.9% of C\u2010IONM group (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05), permanent paralysis in 1.5% of I\u2010IONM vs 1.0% of C\u2010IONM group (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.619). In total, 72 patients (21%) experienced pathological events (19 LOS\u00a0&lt;\u00a0100\u00a0\u03bcV, 53 transient or permanent UVFP). Three patients with permanent UVFP and persisting dysphonia received phonosurgery with stable improvements of all acoustic\u2010aerodynamic parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compared to I\u2010IONM, C\u2010IONM\u2010application in complex benign thyroid surgery shows a significant reduction of transient UVFP and a non\u2010significant trend in preventing permanent UVFP. In persistent UVFP with dysphonia, endolaryngeal phonomicrosurgery and transcervical laryngeal framework surgery are long\u2010term effective treatment approaches to improve vocal function.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13446","type":"journal-article","created":{"date-parts":[[2019,9,30]],"date-time":"2019-09-30T02:34:12Z","timestamp":1569810852000},"page":"1071-1079","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Continuous versus intermittent intraoperative neuromonitoring in complex benign thyroid surgery: A retrospective analysis and prospective follow\u2010up"],"prefix":"10.1111","volume":"44","author":[{"given":"Anke","family":"Sedlmaier","sequence":"first","affiliation":[{"name":"Department of Surgery DRK Kliniken Berlin Westend Berlin 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