Review of the neuromonitoring in thyroid surgery

<p>Introduction and Objectives: The identification of recurrent laryngeal nerve (RLN) during thyroid surgery is considered gold standard to prevent their injury. Electromyographic recordings of the thyroarytenoid muscle activity after electrical stimulation of the vagus or RLN nerves aid during identification of the RLN and reports of their functional status at the end of thyroidectomy. For the record electromyographic two are the most useful techniques: using surface electrodes on the endotracheal tube (ETT) and by needle electrodes inserted into the thyroarytenoid muscles across the cricothyroid membrane (transligamentary technique, TL). Objectives: To review the methods of identification of the RLN in thyroid surgery, the main techniques for neuromonitoring, their validity and summarize practical technical details. Conclusions: The neuromonitoring aid in the location, identification and dissection the RLN, aid in decision-making when there is loss of the electromyographic signal and provides information about the function of NLR at the end of surgery. The neuromonitoring has benefits in clinical practice, research, in teaching and in medical-legal.