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 language | English (US) |
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Pages (from-to) | 1468-1480 |
Number of pages | 13 |
Journal | Head and Neck |
Volume | 44 |
Issue number | 6 |
DOIs | |
State | Published - Jun 2022 |
Keywords
- intraoperative nerve monitoring
- pediatric
- recurrent laryngeal nerve
- thyroid surgery
- vocal cord paralysis
ASJC Scopus subject areas
- Otorhinolaryngology