Practical Applications of Intraoperative Neuromonitoring during Thyroid Surgery
10.11106/ijt.2026.19.1.48
- Author:
Hyoung Shin LEE
1
Author Information
1. Department of Otolaryngology Head and Neck Surgery, Kosin University College of Medicine, Busan, Korea
- Publication Type:REVIEW ARTICLES
- From:International Journal of Thyroidology
2026;19(1):48-51
- CountryRepublic of Korea
- Language:English
-
Abstract:
Recurrent laryngeal nerve (RLN) injury leading to vocal cord paralysis (VCP) remains one of the most consequential complications after thyroid surgery, significantly impairing postoperative quality of life. This article reviews practical clinical applications of intraoperative neuromonitoring (IONM) and discusses how IONM may reduce the incidence of VCP. Through early neural mapping, functional differentiation of RLN branches, and continuous or repeated monitoring during high-risk maneuvers such as traction and tumor shaving, IONM enables surgeons to make intraoperative decisions that balance oncologic safety with functional preservation. In addition, staged surgery guided by IONM findings—particularly in the setting of intraoperative signal deterioration or loss—represents a critical strategy to prevent the catastrophic complication of bilateral VCP. Beyond simple nerve identification, IONM can be applied broadly across diverse operative scenarios; mastering its situation-specific utility is expected to help surgeons further improve postoperative voice-related outcomes and overall patient quality of life.
