Thyroid surgery is associated with a risk of injury to the recurrent laryngeal nerve, especially in the presence of anatomical variants such as a non-recurrent laryngeal nerve (NRLN). Injury to the nerve leads to transient or permanent vocal cord palsy (VCP). A novel method to prevent VCP is continuous intraoperative nerve monitoring (cIONM), but less is known about the applicability of this method in patients with NRLN. The aim of this study was to evaluate our own data regarding feasibility and detailed characteristics of cIONM in NRLN patients. We performed a monocentric retrospective cohort analysis including clinical data and intraoperative nerve monitoring data (measured by Inomed Medizintechnik GmbH, Emmendingen, ‘C2’ and ‘C2 Xplore’ device) of all thyroid surgery patients, showing NRLN between 2014 and 2022. Of 1406 patients who underwent thyroid surgery with cIONM between 2014 and 2022, 12 patients (0.9%) showed NRLN intraoperatively. Notably, cIONM was feasible in eight patients (67%). In all cases the onset latency of the right vagus nerve was shorter (<3.0 ms) than usually expected, suggesting that a short latency might be suitable to distinguish NRLN. None of the patients had a post-operative VCP. Overall, cIONM appears to be feasible and safe in NRLN patients and provides helpful information to prevent VCP.
甲状腺手术存在损伤喉返神经的风险，尤其在存在非典型喉返神经等解剖变异时更为显著。神经损伤可导致暂时性或永久性声带麻痹。连续术中神经监测作为预防声带麻痹的新兴技术，其在非典型喉返神经患者中的应用价值尚不明确。本研究旨在通过分析本中心数据，评估连续术中神经监测在非典型喉返神经患者中的可行性及具体特征。我们采用单中心回顾性队列分析方法，收集2014至2022年间所有甲状腺手术患者的临床资料及术中神经监测数据（使用Inomed Medizintechnik GmbH公司生产的"C2"和"C2 Xplore"设备监测）。在2014至2022年间接受连续术中神经监测的1406例甲状腺手术患者中，术中发现12例（0.9%）存在非典型喉返神经。值得注意的是，其中8例患者（67%）成功实施了连续术中神经监测。所有病例中右侧迷走神经的起始潜伏期均短于常规预期值（<3.0毫秒），提示短潜伏期可能有助于识别非典型喉返神经。术后无一例患者发生声带麻痹。总体而言，连续术中神经监测在非典型喉返神经患者中具有可行性和安全性，能为预防声带麻痹提供有效信息。
肿瘤(癌症)患者之家