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KMID : 1104520170170020042
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Journal of Endocrine Surgery
2017 Volume.17 No. 2 p.42 ~ p.56
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Medico-Legal Issues of Intraoperative Neuromonitoring in Thyroid Surgery
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Kim Hoon-Yub
Liu Xiaoli
Sun Hui
Wu Che-Wei
Chai Young-Jun
Chung Woong-Youn
Tufano Ralph
Dralle Henning
Lavazza Matteo
Dionigi Gianlorenzo
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Abstract
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Advances in intraoperative neuromonitoring (IONM) in thyroid surgery have provided significant insights into recurrent laryngeal nerve function during thyroid surgery. Despite the limitations and necessary caution when using intraoperative monitors to interpret neural function, these technologies have been definite steps in the right direction for assessing neural integrity and safe surgical strategy during thyroid operations. The techniques discussed minimize the adverse sequelae of a variety of thyroid gland procedures, reducing the morbidity rates/risks in the perioperative period. Furthermore, it is likely that such monitoring will become a standard of care. Accurate, reliable and continuous monitoring is essential, and on-going large studies with definable end points will be necessary. The use of monitoring, such as continuous one, may improve cost efficiency by reducing permanent nerve injuries. A danger in this process, however, is the potential for public opinion, outside regulatory bodies, or medico-legal implications to drive change and enforce standards of care before appropriate data are available.
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KEYWORD
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Thyroid gland, Recurrent laryngeal nerve, Malpractice, Recurrent laryngeal nerve injuries, Thyroidectomy
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