Pediatric intraoperative nerve monitoring during thyroid surgery: A review from the American Head and Neck Society Endocrine Surgery Section and the International Neural Monitoring Study Group

Gillian R. Diercks, Jeff C. Rastatter, Ken Kazahaya, Dipti Kamani, Lourdes Quintanilla-Dieck, Maisie L. Shindo, Christopher Hartnick, Jennifer J. Shin, Michael C. Singer, Brendan C. Stack, Amy Y. Chen, Maie A. St. John, Joseph Scharpf, Nishant Agrawal, Asitha D.L. Jayawardena, Ayaka J. Iwata, Okenwa Okose, Bo Wang, Dioan McIlroy, Anthony CheungChe Wei Wu, Feng Yu Chiang, Gianlorenzo Dionigi, Marcin Barczynski, Katrin Brauckhoff, Kerstin Lorenz, Dana Hartl, Neil Tolley, Jennifer A. Brooks, Rick Schneider, Henning Dralle, Amr H. Abdelhamid Ahmed, Gregory W. Randolph

Research output: Contribution to journalReview articlepeer-review

Abstract

Children are more likely to experience recurrent laryngeal nerve (RLN) injury during thyroid surgery. Intraoperative nerve monitoring (IONM) may assist in nerve identification and surgical decision making. A literature review of pediatric IONM was performed and used to inform a monitoring technique guide and expert opinion statements. Pediatric IONM is achieved using a variety of methods. When age-appropriate endotracheal tubes with integrated surface electrodes are not available, an alternative method should be used. Patient age and surgeon experience with laryngoscopy influence technique selection; four techniques are described in detail. Surgeons must be familiar with the nuances of monitoring technique and interpretation; opinion statements address optimizing this technology in children. Adult IONM guidelines may offer strategies for surgical decision making in children. In some cases, delay of second-sided surgery may reduce bilateral RLN injury risk.

Original languageEnglish (US)
Pages (from-to)1468-1480
Number of pages13
JournalHead and Neck
Volume44
Issue number6
DOIs
StateAccepted/In press - 2022
Externally publishedYes

Keywords

  • intraoperative nerve monitoring
  • pediatric
  • recurrent laryngeal nerve
  • thyroid surgery
  • vocal cord paralysis

ASJC Scopus subject areas

  • Otorhinolaryngology

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