Comparative Analysis of Intraoperative Nerve Monitoring (IoNM) with Conventional Thyroidectomy: A 10-Case Study

Objectives: To evaluate the effectiveness of intraoperative nerve monitoring (IoNM) in reducing recurrent laryngeal nerve (RLN) injury and improving surgical outcomes compared to conventional thyroidectomy. Material and Methods: This study at BGS Apollo Hospital, Mysore, included 20 patients (ten with IoNM, ten conventional) from January to July 2023. Outcomes assessed were RLN injury, hypocalcemia, operative time, hospital stay, and vocal cord function. Results: RLN Injury: IoNM group had 10% temporary RLN injuries and no permanent injuries, versus 30% temporary and 10% permanent injuries in the conventional group. Hypocalcemia: Transient hypocalcemia occurred in 20% of the IoNM group and 40% of the conventional group. Operative Time and Hospital Stay: IoNM cases had a slightly longer operative time (110 min) but shorter hospital stay (2.2 days) compared to the conventional group (95 min and 3.1 days). Vocal Cord Function: IoNM group showed minimal voice changes and normal vocal cord mobility, while 40% of the conventional group experienced significant voice issues. Conclusion: IoNM significantly reduces RLN injury and improves recovery, despite a minor increase in operative time. IoNM is recommended for enhancing outcomes in thyroid surgery.