Application of continuous intraoperative neuromonitoring in recurrent laryngeal nerve protection during thyroidectomy

Recurrent laryngeal nerve (RLN) injury is a serious complication of thyroid surgery, which may cause hoarseness of voice or aphonia in patients, or even death. Intraoperative neuromonitoring (IONM) is a technology for identifying the integrity of nerves during operation by electrophysiological means, so as to reduce the chance of RLN injury. Continuous intraoperative neuromonitoring (C-IONM) can provide real-time monitoring of the vagus nerve (VN) in order to prevent RLN damages, overcoming the disadvantages of IONM. This paper reviews the application of C-IONM technology in thyroid surgery, including its technical mechanism, procedures, advantages, safety and so on.