Intermittent intraoperative nerve monitoring in thyroid reoperations: Preliminary results of a randomized, single-surgeon study.

Background. The purpose of this study was to evaluate whether intermittent intraoperative nerve monitoring (IONM) could reduce the incidence of recurrent laryngeal nerve (RLN) paralysis in thyroid reoperations. Methods. Enrolled patients were randomly assigned into the nerve integrity monitor (NIM) group and the control group. Results. The incidence of temporary RLN paralysis and permanent RLN paralysis was 12.2% and 4.9% in the NIM group compared with 7.0% and 2.3% in the control group (p = .658 and p = .966, respectively). The incidence of surgeon-related paralysis, tumor-related paralysis, and scar-related paralysis was 4.9%, 7.3%, and 4.9% in the NIM group compared with 4.7%, 2.3%, and 2.3% in the control group, respectively (p = 1, p = .575, and p = .966, respectively). Conclusion. Intermittent IONM could not provide additional benefits to reduce the incidence of temporary RLN paralysis and permanent RLN paralysis in thyroid reoperations. It could not reduce the incidence of paralysis caused by unintentional injuries. (C) 2016 Wiley Periodicals, Inc.