Cochrane · systematic review · CD012483
Intraoperative neuromonitoring versus visual nerve identification for prevention of recurrent laryngeal nerve injury in adults undergoing thyroid surgery
Cirocchi, R, Arezzo, A, D'Andrea, V, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
Metabolic and Endocrine DisordersAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
7
current version
GRADE rated
5
No studies
2
Included studies
NR
No studies 2 · 28.6%Ungraded 0 · 0%Very low 4 · 57.1%Low 0 · 0%Moderate 1 · 14.3%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Intraoperative neuromonitoring compared to visual nerve identification only during thyroidectomy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Permanent RILN palsy (nerves) Definition: injury detected clinically, by laryngoscopy or both, in which the motility of the vocal cords did not recover within 6 months after surgery Intraoperative neuromonitoring vs visual nerve identification only during thyroidectomy | RR 0.77 [0.33, 1.77] | 4 studies · 2895 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Transient RILN palsy (nerves) Definition: injury detected clinically, by laryngoscopy or both, in which the motility of the vocal cords recovered within 6 months after surgery Intraoperative neuromonitoring vs visual nerve identification only during thyroidectomy | RR 0.62 [0.35, 1.08] | 4 studies · 2895 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Health‐related quality of life Intraoperative neuromonitoring vs visual nerve identification only during thyroidectomy | no estimate extracted | NR | No studies |
Adverse events other than RILN palsy (participants) Definition: transient hypoparathyroidism Intraoperative neuromonitoring vs visual nerve identification only during thyroidectomy | RR 1.25 [0.45, 3.47] | 2 studies · 286 participants | Very low Downgraded: imprecision, inconsistency |
Operative time (min) Definition: time from the first skin incision to skin closure Intraoperative neuromonitoring vs visual nerve identification only during thyroidectomy | no estimate extracted | 3 studies · 1251 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
All‐cause mortality (nerves) Intraoperative neuromonitoring vs visual nerve identification only during thyroidectomy | no estimate extracted | 3 studies · 1438 participants | Moderate Downgraded: imprecision |
Socioeconomic effects Intraoperative neuromonitoring vs visual nerve identification only during thyroidectomy | no estimate extracted | NR | No studies |