Intraoperative nerve monitoring in thyroid and parathyroid surgery: a decade of Italian practice

Intraoperative nerve monitoring (IONM) has been recognized as a useful adjunct into the field of thyroid and parathyroid surgery, aiding in the accurate identification and preservation of the recurrent laryngeal nerve (RLN), consequently reducing the probability of nerve injury and promoting surgical safety. This investigation seeks to amplify the findings of a similar nationwide survey performed in 2014 by offering an updated assessment of IONM practices among Italian surgical institutions, reflecting a decade of advancements and transformations in clinical approaches. A comprehensive nationwide survey was implemented targeting Italian endocrine surgeons to assess the prevalence, utilization patterns, attitudes and perceptions surrounding IONM in the context of thyroid and parathyroid surgical procedures. Structured questionnaires were administered to seventy endocrine surgery centers, and the resulting data were evaluated employing both quantitative and qualitative analysis methods. The survey disclosed that 67.14% of the participants confirmed the routine deployment of IONM across all cervical surgical procedures, particularly in high-risk contexts. Relative to the findings from 2014, a marked rise in the implementation of IONM has been recorded; however, variability persists, especially between continuous and intermittent monitoring strategies. Surgeons recognized improved surgical safety, decreased complication frequencies, and educational advantages as significant key drivers for the incorporation of IONM. Nonetheless, issues, such as false-positive and false-negative results, along with the lack of standardized protocols, remain barriers to its uniform application. During the past ten years, IONM has been thoroughly adopted by Italian endocrine surgeons as a result of its critical contribution to the improvement of surgical outcomes and the provision of educational resources. However, the results highlight the imperative for further standardization of protocols, the advancement of training programs, and the resolution of reimbursement obstacles to ensure equitable and consistent application of IONM across Italian centers, ultimately optimizing patient care.

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Publication Details

Journal
Updates in Surgery
Published
2025-04-01
DOI
https://doi.org/10.1007/s13304-025-02157-6
Citations
2
Primary Topic
Thyroid and Parathyroid Surgery
Type
article
Field-Weighted Citation Impact
4.01
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article

Intraoperative nerve monitoring in thyroid and parathyroid surgery: a decade of Italian practice

L Rosato, Paolo Del Rio, Giuseppe Cavallaro, F Scolari et al.
2 citations
Updates in Surgery
Thyroid and Parathyroid Surgery
4.01
article

Intraoperative nerve monitoring in thyroid and parathyroid surgery: a decade of Italian practice

L Rosato, Paolo Del Rio, Giuseppe Cavallaro, F Scolari, Michele Minuto, Luciano Giacomelli, Francesco Quaglino, Angela Pezzolla, Marco Raffaelli, Sara Andreani, C De Crea, Nadia Innaro, G Lupone, Rebecca Panconesi, N Palestini, Maurizio Iacobone, Pietro Princi, Barbara Mullineris, Chiara Dobrinja, Mario Testini, Giuseppa Graceffa, Marco Biffoni, Andrea Casaril, E Leopaldi, Emanuela Traini, I Pisano, I Pauna, Fabrizio Consorti, Angela Gurrado, Giovanni Docimo, Maria Grazia Chiofalo, Rossella Melcarne, Loredana De Pasquale, Aldo Bove, G Basili, Nicola Avenia, Marco Bononi, Gabriele Materazzi, Grégorio Scerrino, Pietro Giorgio Calò, D Bettini, Paola Sartori, Piera Aiello, C Bellotti
article en
2 citations

Abstract

Intraoperative nerve monitoring (IONM) has been recognized as a useful adjunct into the field of thyroid and parathyroid surgery, aiding in the accurate identification and preservation of the recurrent laryngeal nerve (RLN), consequently reducing the probability of nerve injury and promoting surgical safety. This investigation seeks to amplify the findings of a similar nationwide survey performed in 2014 by offering an updated assessment of IONM practices among Italian surgical institutions, reflecting a decade of advancements and transformations in clinical approaches. A comprehensive nationwide survey was implemented targeting Italian endocrine surgeons to assess the prevalence, utilization patterns, attitudes and perceptions surrounding IONM in the context of thyroid and parathyroid surgical procedures. Structured questionnaires were administered to seventy endocrine surgery centers, and the resulting data were evaluated employing both quantitative and qualitative analysis methods. The survey disclosed that 67.14% of the participants confirmed the routine deployment of IONM across all cervical surgical procedures, particularly in high-risk contexts. Relative to the findings from 2014, a marked rise in the implementation of IONM has been recorded; however, variability persists, especially between continuous and intermittent monitoring strategies. Surgeons recognized improved surgical safety, decreased complication frequencies, and educational advantages as significant key drivers for the incorporation of IONM. Nonetheless, issues, such as false-positive and false-negative results, along with the lack of standardized protocols, remain barriers to its uniform application. During the past ten years, IONM has been thoroughly adopted by Italian endocrine surgeons as a result of its critical contribution to the improvement of surgical outcomes and the provision of educational resources. However, the results highlight the imperative for further standardization of protocols, the advancement of training programs, and the resolution of reimbursement obstacles to ensure equitable and consistent application of IONM across Italian centers, ultimately optimizing patient care.

Updates in SurgeryVol. 77(5)
Università Cattolica del Sacro Cuore (IT), University of Parma (IT), AOL (United States) (US), University of Padua (IT), University of Sassari (IT), University of Cagliari (IT), University of Campania "Luigi Vanvitelli" (IT), University of Perugia (IT), Santa Maria Nuova Hospital (IT), Policlinico Umberto I (IT), Agostino Gemelli University Polyclinic (IT), Magna Graecia University (IT), University of Chieti-Pescara (IT), Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT), Ospedale di Cattinara (IT), Ospedale San Carlo (IT), Fatebenefratelli Hospital (IT), Casa di Cura Villa Garda (IT), Ospedale Civile Di Ivrea (IT), Ospedale Cristo Re (IT), Ospedale San Paolo (IT), Ospedale G.B. Morgagni - L.Pierantoni (IT), Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale" (IT), Ospedale Maria Vittoria (IT), Ospedale Policlinico San Martino (IT), Istituti di Ricovero e Cura a Carattere Scientifico (IT), Azienda Usl Toscana Centro (IT), IRCCS Humanitas Research Hospital (IT), Azienda Ospedaliera Universitaria Pisana (IT), Interventi Geo Ambientali (Italy) (IT), University of Florence (IT), University of Bari Aldo Moro (IT), University of Genoa (IT), Sapienza University of Rome (IT), University of Palermo (IT)
Openalex Percentile: Top 8%
Thyroid and Parathyroid Surgery
4.01
DOIOpen Access PDFOpenAlex
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