Indian Expert Consensus on the Use and Best Practices of IONM in Thyroid Surgery

Abstract Introduction Intraoperative neuromonitoring (IONM) has been well established for its benefits in nerve identification, early detection of functional impairment, and other benefits in thyroid surgery. However, an updated consensus guideline on its overall benefits and use in routine practice in thyroid surgeries in India does not exist. We assembled an expert panel to develop, refine, and vote for a set of consensus statements. Method A preliminary literature review was conducted on various aspects of IONM in thyroid surgery to develop consensus statements. A modified Delphi method was followed to discuss, edit, modify, and vote on the statements. Results 18 statements were developed after the literature review. Upon the first round, modifications were suggested for 17 statements, and one statement was eliminated due to overlap. In the second round, 17 statements received consensus, and one statement was added upon suggestion from the experts. Round 3 was conducted online, and all 18 statements received consensus. Conclusion A final core set of 18 statements, divided into 9 categories was developed, covering the multiple aspects of IONM. These statements can serve as evidence-based expert guidelines to enhance quality and promote consistency in thyroid surgery practice involving IONM.