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KMID : 1104520180180010049
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Journal of Endocrine Surgery
2018 Volume.18 No. 1 p.49 ~ p.60
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Intraoperative Neural Monitoring in Thyroid Surgery: Role and Responsibility of Surgeon
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Kim Hoon-Yub
Tufano Ralph P.
Chai Young-Jun
Barczynski Marcin
Makay Ozer
Wu Che-Wei
Berber Eren
Sun Hui
Dionigi Gianlorenzo
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Abstract
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Surgeons who introduce intraoperative neural monitoring (IONM) or a new IONM accessory, or related procedure in their practice should have completed relevant surgical training, possess operating privileges in the affected endocrine system, and be able to address anticipated complications. Surgeon responsibility in monitoring is dual component. First, technical component is using and setting up the IONM equipment correctly and understanding the inherent properties of the system to avoid an erroneous setup (e.g., no muscle relaxation, correct electrode placement, low impedance, etc.). Second, interpretive component is performing the monitoring able to distinguish between a true response versus an artifactual one. Organizations such as the International Neural Study Group and the Korean Intraoperative Neural Monitoring Society provide training courses for surgeon, as well as a means to certify levels of monitoring interpretative competence.
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KEYWORD
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Neural monitoring, Thyroid surgery, Recurrent laryngeal nerve, Training
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