Recurrent Laryngeal Nerve Intraoperative Neuromonitoring Indications in Non-Thyroid and Non-Parathyroid Surgery

Aina Brunet; Aleix Rovira; Miquel Quer; Alvaro Sanabria; Orlando Guntinas-Lichius; Mark Zafereo; Dana M Hartl; Andrés Coca-Pelaz; Ashok R Shaha; Jean-Paul Marie; Vincent Vander Poorten; Cesare Piazza; Luiz P Kowalski; Gregory W Randolph; Jatin P Shah; Alessandra Rinaldo; Ricard Simo

doi:10.3390/jcm13082221

Recurrent Laryngeal Nerve Intraoperative Neuromonitoring Indications in Non-Thyroid and Non-Parathyroid Surgery

J Clin Med. 2024 Apr 11;13(8):2221. doi: 10.3390/jcm13082221.

Authors

Aina Brunet^{1

2}, Aleix Rovira³, Miquel Quer⁴, Alvaro Sanabria⁵, Orlando Guntinas-Lichius⁶, Mark Zafereo⁷, Dana M Hartl⁸, Andrés Coca-Pelaz⁹, Ashok R Shaha¹⁰, Jean-Paul Marie¹¹, Vincent Vander Poorten¹², Cesare Piazza¹³, Luiz P Kowalski¹⁴, Gregory W Randolph¹⁵, Jatin P Shah¹⁶, Alessandra Rinaldo¹⁷, Ricard Simo^{3

18}

Affiliations

¹ Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Universitari Bellvitge, Universitat de Barcelona, 08907 Barcelona, Spain.
² Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
³ Department of Otorhinolaryngology, Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London SE1 9RT, UK.
⁴ Department of Otorhinolaryngology, Head and Neck Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08025 Barcelona, Spain.
⁵ Department of Surgery, Universidad de Antioquia, Hospital Universitario San Vicente Fundación, CEXCA Centro de Excelencia en Enfermedades de Cabeza y Cuello, Medellin 1226, Colombia.
⁶ Department of Otorhinolaryngology, Head and Neck Surgery, Jena University Hospital, 07747 Jena, Germany.
⁷ Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, TX 77030, USA.
⁸ Thyroid Surgery Unit, Department of Otorhinolaryngology Head and Neck Surgery, Institute Gustave Roussy, 94805 Paris, France.
⁹ Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, 33011 Oviedo, Spain.
¹⁰ Department of Head and Neck Surgery, Memorial Sloan-Kettering Cancer Center, Medical College, Cornell University, New York, NY 10065, USA.
¹¹ Department of Otorhinolaryngology Head and Neck Surgery, Institute of Biomedical Research, University Hospital Rouen, 76000 Rouen, France.
¹² Department of Otorhinolaryngology Head and Neck Surgery, University Hospitals Leuven, 3000 Leuven, Belgium.
¹³ Department of Otorhinolaryngology Head and Neck Surgery, ASST Spedali Civili of Brescha, School of Medicine, University of Brescia, 25123 Brescia, Italy.
¹⁴ Department of Otorhinolaryngology Head and Neck Surgery, A.C. Camargo Cancer Center, Faculty of Medicine, University of Sao Paulo, São Paulo 03828-000, Brazil.
¹⁵ Department of Otorhinolaryngology, Division of Thyroid and Parathyroid Endocrine Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA.
¹⁶ Department of Surgery, Memorial Sloan-Kettering Cancer Center, Weil Medical College, Cornell University, New York, NY 10065, USA.
¹⁷ School of Medicine, University of Udine, 33100 Udine, Italy.
¹⁸ King's College London, London SE5 8AF, UK.

Abstract

Introperative nerve monitoring (IONM) of the recurrent laryngeal nerve (RLN) is a well-established technique to aid in thyroid/parathyroid surgery. However, there is little evidence to support its use in non-thyroid or non-parathyroid surgery. The aim of this paper was to review the current evidence regarding the use of IONM in non-thyroid/non-parathyroid surgery in the head and neck and thorax. A literature search was performed from their inception up to January 2024, including the term "recurrent laryngeal nerve monitoring". IONM in non-thyroid/non-parathyroid surgery has mainly been previously described in oesophageal surgery and in tracheal resections. However, there is little published evidence on the role of IONM with other resections in the vicinity of the RLN. Current evidence is low-level for the use of RLN IONM in non-thyroid/non-parathyroid surgery. However, clinicians should consider its use in surgery for pathologies where the RLN is exposed and could be injured.

Keywords: intraoperative nerve monitoring; oesophagus; recurrent laryngeal nerve; recurrent laryngeal nerve palsy; trachea.

Publication types

Review

Grants and funding

P30 CA008748/CA/NCI NIH HHS/United States