Role of intraoperative recurrent laryngeal nerve monitoring for pediatric thyroid surgery: Comparative analysis

Background: The data on the advantages of intraoperative nerve monitoring (IONM) during pediatric thyroid surgeries are limited. We aimed to study the role of IONM by comparing between children who underwent thyroid surgery with and without IONM. Methods: A retrospective study of all children who underwent thyroid surgery between 2001 and 2019. Results: The study included 113 patients with 183 recurrent laryngeal nerve (RLN) at risk. Transient paralysis rate was more than 5-fold lower in the IONM group compared to the control group (1.5% vs 8%; P =.114). Permanent paralysis was documented only in the control group (2.5% vs 0%; P =.552). Children <10 years and those who underwent central neck dissection had significantly higher rates of RLN injury. Conclusions: IONM was associated with decreased rate of RLN injury during pediatric thyroid surgery and should be considered especially in children under 10 years of age and those undergoing concomitant central neck dissection.