The learning curve for intraoperative neuromonitoring of the recurrent laryngeal nerve in thyroid surgery.

摘要: Intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) is often used in thyroid surgery. However, this procedure complex and requires a learning period to master technique. The aim study was evaluate curve for IONM. A 3-year (2012–2014) working with IONM (NIM3.0, Medtronic) prospectively analyzed special emphasis on comparing initial implementation phase 2012 (101 patients, 190 RLNs at risk) subsequent years use 2013 (70 124 2014 (65 120 risk). rate successful IONM-assisted RLN identification increased gradually over (92.11 % vs. 95.16 % 99.16 % 2014; p = 0.022), corresponding decrease technical problems (12.87, 4.3, 4.6 %, respectively; p = 0.039). injuries tended time: 3.68, 1.55, 0.83 %, respectively (p = 0.220). Between 2014, increases sensitivity (71.4 100 %), specificity (98 99 %), positive predictive value (62.5 75 %), negative overall accuracy (97.4 99.6 %) were observed (p = 0.049). Increasing experience resulted more frequent utilization total thyroidectomy (92 % 100 % 2013–2014; p = 0.004). There sharp number involving equipment setup from 2014.