Abstract
<jats:p>Objective. To evaluate the impact of intraoperative neuromonitoring on the identification of the recurrent laryngeal nerve and the incidence of its postoperative paresis/paralysis. Materials and Methods. Data from 100 patients were analyzed: 50 underwent surgery using intraoperative neuromonitoring, and 50 using visual identification of the recurrent laryngeal nerve. Recurrent laryngeal nerve function was assessed laryngoscopically; nerve motility impairment was considered transient if recovery took less than 6 months. Results. Bilateral identification of the recurrent laryngeal nerve was achieved in 100% of patients who underwent intraoperative neuromonitoring and in 74% of patients who underwent visual identification (p < 0.001). Transient nerve palsy/paralysis occurred in 8% and 16% of patients, respectively. In patients who underwent intraoperative neuromonitoring, no permanent paresis was recorded, whereas 6% of patients who underwent visual identification developed permanent paresis, and 1 patient experienced bilateral paralysis requiring tracheostomy. Conclusions. Intraoperative neuromonitoring during thyroidectomy improves identification of the recurrent laryngeal nerve and is associated with a lower incidence of postoperative complications; in particular, it makes it possible to avoid permanent paralysis and potentially prevent bilateral nerve damage.</jats:p>