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Abstract：
Intraoperative neural monitoring (IONM) during thyroid surgery has gained widespread acceptance as an adjunct to the gold standard of visual identification of the recurrent laryngeal nerve (RLN). Contrary to routine dissection of the RLN, most surgeons tend to avoid rather than routinely expose and identify the external branch of the superior laryngeal nerve (EBSLN) during thyroidectomy or parathyroidectomy. IONM has the potential to be utilized for identification of the EBSLN and functional assessment of its integrity; therefore, IONM might contribute to voice preservation following thyroidectomy or parathyroidectomy. We reviewed the literature and the cumulative experience of the multidisciplinary International Neural Monitoring Study Group (INMSG) with IONM of the EBSLN. A systematic search of the MEDLINE database (from 1950 to the present) with predefined search terms (EBSLN, superior laryngeal nerve, stimulation, neuromonitoring, identification) was undertaken and supplemented by personal communication between members of the INMSG to identify relevant publications in the field. The hypothesis explored in this review is that the use of a standardized approach to the functional preservation of the EBSLN can be facilitated by application of IONM resulting in improved preservation of voice following thyroidectomy or parathyroidectomy. These guidelines are intended to improve the practice of neural monitoring of the EBSLN during thyroidectomy or parathyroidectomy and to optimize clinical utility of this technique based on available evidence and consensus of experts.
METHODS: 5
METHODS: 5
摘要：
甲状腺手术期间的术中神经监测（IONM）已被广泛接受，作为视觉识别喉返神经（RLN）的金标准的辅助手段。与常规的RLN解剖相反，在甲状腺切除术或甲状旁腺切除术期间,大多数外科医生倾向于避免而不是常规地暴露和识别喉上神经(EBSLN)的外部分支.IONM有可能用于识别EBSLN和对其完整性进行功能评估；因此，IONM可能有助于甲状腺切除术或甲状旁腺切除术后的语音保留。我们回顾了多学科国际神经监测研究组（INMSG）与EBSLNIONM的文献和累积经验。使用预定义的搜索词（EBSLN，喉上神经,刺激,神经监测,识别）由INMSG成员之间的个人通信进行和补充，以识别该领域的相关出版物。这篇综述中探讨的假设是，通过应用IONM可以促进使用标准化方法来保护EBSLN的功能，从而改善甲状腺切除术或甲状旁腺切除术后的语音保存。这些指南旨在改善甲状腺切除术或甲状旁腺切除术期间EBSLN的神经监测实践，并根据现有证据和专家共识优化该技术的临床实用性。
方法：5
方法：5
