IONM of the recurrent laryngeal nerve

Gianlorenzo Dionigi*, Henning Dralle, Whitney Liddy, Dipti Kamani, Natalia Kyriazidis, Gregory W. Randolph

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapter

5 Scopus citations


Thyroid surgery can pose risk to both the right and the left recurrent laryngeal nerves (RLN) in a single surgical procedure. Unilateral vocal cord palsy (VCP) can lead to morbidity related to changes in voice, especially in professional voice users, as well as potential dysphagia and aspiration, while bilateral VCP may require tracheostomy. Visualization of the RLN during surgery has been considered the gold standard for preventing injury to the RLN; however, an intraoperatively visualized and structurally intact nerve does not necessarily represent a postoperatively functioning nerve. Neural monitoring has increasingly gained the attention of surgeons performing thyroid and parathyroid surgeries around the world. Current studies suggest that a majority of general and head and neck surgeons use neural monitoring in at least some of their thyroid surgical cases. This chapter presents a historical overview and usage patterns of intraoperative neural monitoring (IONM) of the RLN and discusses its impact on surgical practice, including intraoperative applications of IONM, medicolegal aspects and standards of IONM, normative data, as well as current advances in IONM such as continuous IONM.

Original languageEnglish (US)
Title of host publicationThe Recurrent and Superior Laryngeal Nerves
PublisherSpringer International Publishing
Number of pages22
ISBN (Electronic)9783319277271
ISBN (Print)9783319277257
StatePublished - May 27 2016


  • Injury to rln
  • Ionm
  • Medicolegal issues in thyroid surgery
  • Rln
  • Standards of ionm
  • Thyroid surgery
  • Vocal cord paralysis

ASJC Scopus subject areas

  • General Medicine


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