Intraoperative neuromonitoring in thyroid and parathyroid surgery: indications and method

Intraoperative neuromonitoring finds widespread application in thyroid and parathyroid surgery, as a preventive method against laryngeal nerves injuries. Today it is possible to monitor the laryngeal nerve function in real time during an operation. In this article based on experience of 1065 thyroid and parathyroid operations with intraoperative neuromonitoring, we describe in details the procedure of intraoperative neuromonitoring of laryngeal nerves: features of anaesthesia, endotracheal tube position, algorythm of trouble shooting in case of loss of electromyographical sygnal. Besides that, there is an explanation of electromyographical indices, such as: signal amplitude, latency, threshold, LOS (loss of signal); there are main literature sources on this problem.