Application Of Recurrent Laryngeal Nerve Monitoring Technique In Thyroid Malignant Tumor Surgery

Objective:By comparing intraoperative assisted recurrent laryngeal nerve monitoring techniques with conventional exposure of the recurrent laryngeal nerves,to evaluated whether the use of recurrent laryngeal nerve monitoring in thyroid malignancy surgery can effectively protect the recurrent laryngeal nerve.Methods:120 patients with thyroid cancer were choosed who underwent unilateral thyroid gland leaf + isthmus resection with central lymph node dissection in the First Affiliated Hospital of Hebei North University,during the period from August 2017 to August 2018.They underwent electronic nose laryngoscopy and the vocal cord activity was normal before operation.After the approval by the Ethics Committee of the First Affiliated Hospital of Hebei North University,120 patients with thyroid cancer surgery were enrolled in the informed consent form were randomly divided into the neurological monitoring group(n=60)and the control group(n=60).The monitoring group used the NIM-Response 3.0 nerve monitor produced by Medtronics Xomed Company of the United States to perform recurrent laryngeal nerve monitoring.The control group routinely exposed the recurrent laryngeal nerve.The time of looking for recurrent laryngeal nerve,the amount of intraoperative blood loss and the number of recurrent laryngeal nerve injury were recorded between the two groups.The voice condition and the vocal cord activity of the electronic nose laryngoscope were recorded regularly.Intraoperative data were assisted by the operating room roving nurse.Results:The time of looking for the recurrent laryngeal nerve was compared between the two groups.The monitoring group was(12.25±2.43)min,the control group was(12.41±2.43)min,P=0.71,the difference was not statistically significant(P>0.05).The intraoperative blood loss in the two groups was(22.75±5.56)ml in the monitoring group and(23.61±4.78)ml in the control group,P=0.36,the difference was not statistically significant(P>0.05).In the two groups,60 recurrent laryngeal nerves were confirmed in the operation.20% of the patients in the control group experienced transient neurological impairment.In the monitoring group,temporary nerve injury occurred in the monitoring group(6.7%).The data of the two groups were compared,P=0.00,the difference was statistically significant(P<0.05).The permanent injury rate was 0% in the monitoring group and 5% in the control group.The data of the two groups were compared,P=0.08,the difference was not statistically significant(P>0.05).Conclusions:Intraoperative use of recurrent laryngeal nerve monitoring is superior to conventional exposure in reducing temporary laryngeal nerve injury.