Does intraoperative neuromonitoring during thyroidectomy reduce the risk of hypoparathyroidism?

Abstract

Objectives: To evaluate the effect of intraoperative neuromonitoring on postoperative hypoparathyroidism after bilateral total thyroidectomy.

Method: The prospective study was conducted at the General Surgery Clinic of the University of Health Sciences Haseki Training and Research Hospital, Turkiye, from February 2016 to December 2020, and comprised patients who had undergone bilateral total thyroidectomy. They were evaluated for recurrent laryngeal nerve damage, hypocalcaemia and hypoparathyroidism. Further, it was explored whether the use of intraoperative neuromonitoring had an effect on postoperative complications between experienced surgeons with >5 years of experience and less-experienced surgeons with <5 years of experience. Data was analysed using SPSS 15.

Results: Of the 64 patients 59(92.2%) were females and 5(7.8%) were males. The overall mean age was 47.7±10.8 years. Experienced surgeons operated 38(59.4%) patients, while the less experienced operated 26(40.6%). The most common complications were transient hypocalcaemia 38(59.3%) and transient unilateral vocal cord paralysis 9(14%). There was no significant difference between experienced surgeons and less experienced surgeons in terms of postoperative complications (p>0.05).

Conclusion: The use of intraoperative neuromonitoring during bilateral total thyroidectomy reduced the risk of hypoparathyroidism regardless of the surgeon's experience.

Key Words: Thyroidectomy, Vocal cord paralysis, Hypocalcaemia, Recurrent laryngeal nerve, Postoperative complications, Hypoparathyroidism.