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The current state of intermittent intraoperative neural monitoring for prevention of recurrent laryngeal nerve injury during thyroidectomy: a PRISMA-compliant systematic review of overlapping meta-analyses

PURPOSE: Recurrent laryngeal nerve (RLN) injury is one of the most common and detrimental complications following thyroidectomy. Intermittent intraoperative nerve monitoring (I-IONM) has been proposed to reduce prevalence of RLN injury following thyroidectomy and has gained increasing acceptance in...

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Autores principales: Henry, Brandon Michael, Graves, Matthew J., Vikse, Jens, Sanna, Beatrice, Pękala, Przemysław A., Walocha, Jerzy A., Barczyński, Marcin, Tomaszewski, Krzysztof A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5437188/
https://www.ncbi.nlm.nih.gov/pubmed/28378238
http://dx.doi.org/10.1007/s00423-017-1580-y
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author Henry, Brandon Michael
Graves, Matthew J.
Vikse, Jens
Sanna, Beatrice
Pękala, Przemysław A.
Walocha, Jerzy A.
Barczyński, Marcin
Tomaszewski, Krzysztof A.
author_facet Henry, Brandon Michael
Graves, Matthew J.
Vikse, Jens
Sanna, Beatrice
Pękala, Przemysław A.
Walocha, Jerzy A.
Barczyński, Marcin
Tomaszewski, Krzysztof A.
author_sort Henry, Brandon Michael
collection PubMed
description PURPOSE: Recurrent laryngeal nerve (RLN) injury is one of the most common and detrimental complications following thyroidectomy. Intermittent intraoperative nerve monitoring (I-IONM) has been proposed to reduce prevalence of RLN injury following thyroidectomy and has gained increasing acceptance in recent years. METHODS: A comprehensive database search was performed, and data from eligible meta-analyses meeting the inclusion criteria were extracted. Transient, permanent, and overall RLN injuries were the primary outcome measures. Quality assessment via AMSTAR, heterogeneity appraisal, and selection of best evidence was performed via a Jadad algorithm. RESULTS: Eight meta-analyses met the inclusion criteria. Meta-analyses included between 6 and 23 original studies each. Via utilization of the Jadad algorithm, the selection of best evidence resulted in choosing of Pisanu et al. (Surg Res 188:152–161, 2014). Five out of eight meta-analyses demonstrated non-significant (p > 0.05) RLN injury reduction with the use of I-IONM versus nerve visualization alone. CONCLUSIONS: To date, I-IONM has not achieved a significant level of RLN injury reduction as shown by the meta-analysis conducted by Pisanu et al. (Surg Res 188:152–161, 2014). However, most recent developments of IONM technology including continuous vagal IONM and concept of staged thyroidectomy in case of loss of signal on the first side in order to prevent bilateral RLN injury may provide additional benefits which were out of the scope of this study and need to be assessed in further prospective multicenter trials. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00423-017-1580-y) contains supplementary material, which is available to authorized users.
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spelling pubmed-54371882017-06-06 The current state of intermittent intraoperative neural monitoring for prevention of recurrent laryngeal nerve injury during thyroidectomy: a PRISMA-compliant systematic review of overlapping meta-analyses Henry, Brandon Michael Graves, Matthew J. Vikse, Jens Sanna, Beatrice Pękala, Przemysław A. Walocha, Jerzy A. Barczyński, Marcin Tomaszewski, Krzysztof A. Langenbecks Arch Surg Systematic Reviews and Meta-analyses PURPOSE: Recurrent laryngeal nerve (RLN) injury is one of the most common and detrimental complications following thyroidectomy. Intermittent intraoperative nerve monitoring (I-IONM) has been proposed to reduce prevalence of RLN injury following thyroidectomy and has gained increasing acceptance in recent years. METHODS: A comprehensive database search was performed, and data from eligible meta-analyses meeting the inclusion criteria were extracted. Transient, permanent, and overall RLN injuries were the primary outcome measures. Quality assessment via AMSTAR, heterogeneity appraisal, and selection of best evidence was performed via a Jadad algorithm. RESULTS: Eight meta-analyses met the inclusion criteria. Meta-analyses included between 6 and 23 original studies each. Via utilization of the Jadad algorithm, the selection of best evidence resulted in choosing of Pisanu et al. (Surg Res 188:152–161, 2014). Five out of eight meta-analyses demonstrated non-significant (p > 0.05) RLN injury reduction with the use of I-IONM versus nerve visualization alone. CONCLUSIONS: To date, I-IONM has not achieved a significant level of RLN injury reduction as shown by the meta-analysis conducted by Pisanu et al. (Surg Res 188:152–161, 2014). However, most recent developments of IONM technology including continuous vagal IONM and concept of staged thyroidectomy in case of loss of signal on the first side in order to prevent bilateral RLN injury may provide additional benefits which were out of the scope of this study and need to be assessed in further prospective multicenter trials. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00423-017-1580-y) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2017-04-04 2017 /pmc/articles/PMC5437188/ /pubmed/28378238 http://dx.doi.org/10.1007/s00423-017-1580-y Text en © The Author(s) 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Systematic Reviews and Meta-analyses
Henry, Brandon Michael
Graves, Matthew J.
Vikse, Jens
Sanna, Beatrice
Pękala, Przemysław A.
Walocha, Jerzy A.
Barczyński, Marcin
Tomaszewski, Krzysztof A.
The current state of intermittent intraoperative neural monitoring for prevention of recurrent laryngeal nerve injury during thyroidectomy: a PRISMA-compliant systematic review of overlapping meta-analyses
title The current state of intermittent intraoperative neural monitoring for prevention of recurrent laryngeal nerve injury during thyroidectomy: a PRISMA-compliant systematic review of overlapping meta-analyses
title_full The current state of intermittent intraoperative neural monitoring for prevention of recurrent laryngeal nerve injury during thyroidectomy: a PRISMA-compliant systematic review of overlapping meta-analyses
title_fullStr The current state of intermittent intraoperative neural monitoring for prevention of recurrent laryngeal nerve injury during thyroidectomy: a PRISMA-compliant systematic review of overlapping meta-analyses
title_full_unstemmed The current state of intermittent intraoperative neural monitoring for prevention of recurrent laryngeal nerve injury during thyroidectomy: a PRISMA-compliant systematic review of overlapping meta-analyses
title_short The current state of intermittent intraoperative neural monitoring for prevention of recurrent laryngeal nerve injury during thyroidectomy: a PRISMA-compliant systematic review of overlapping meta-analyses
title_sort current state of intermittent intraoperative neural monitoring for prevention of recurrent laryngeal nerve injury during thyroidectomy: a prisma-compliant systematic review of overlapping meta-analyses
topic Systematic Reviews and Meta-analyses
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5437188/
https://www.ncbi.nlm.nih.gov/pubmed/28378238
http://dx.doi.org/10.1007/s00423-017-1580-y
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