Comparing the morbidity of external laryngeal nerve injury in thyroid surgery with and without identifying the nerve using intraoperative neuromonitoring.

OBJECTIVE To describe and determine the possibility of surgical trauma to the external branch of the superior laryngeal nerve and to assess the role of intraoperative neuromonitoring in thyroid surgery. DESIGN AND SETTING Prospective, randomized, controlled study in a teaching Hospital Universiti Sains Malaysia (HUSM), Kota Bharu, Kelantan, Malaysia. SUBJECTS Forty two patients of both genders, whom underwent thyroid surgery divided into two groups (21 patients control group and 21 patients study group) in HUSM and were randomly selected for our study. METHODS The use of nerve monitoring and proper surgical technique of upper thyroid pole dissection followed by its lateralization and exposure of cricothyroid space were performed in each subject in study group in order to preserve EBSLN after its identification. In control group upper thyroid vessels were ligated close to the upper thyroid pole without any effort of EBSLN identification. RESULTS Total of 42 (35 females and 7 males) patients who underwent thyroid surgery in a period of 2 years. Evaluation of all subjects 1 case in control group presented with symptoms of EBSLN injury. CONCLUSION Intraoperative identification and neuromonitoring can avoid injury to the EBSLN and prevent its sequential changes in voice especially for those who professionally depend to their voice.