Paradigms of intraoperative neuromonitoring in paediatric thyroid surgery
The larynx of children and adolescents is still in the developmental phase and the anatomical structure is still very small and sensitive. The higher malignancy and faster progression of some paediatric thyroid cancers make surgery more difficult. Intraoperative neuromonitoring (IONM) is frequently...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-01-01
|
| Series: | Frontiers in Endocrinology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2024.1455217/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832582215378141184 |
|---|---|
| author | Yuchuan Li Chunhai Zhang Yi Zhang Gianlorenzo Dionigi Gianlorenzo Dionigi Yishen Zhao Hui Sun Hui Sun Yingying Wang |
| author_facet | Yuchuan Li Chunhai Zhang Yi Zhang Gianlorenzo Dionigi Gianlorenzo Dionigi Yishen Zhao Hui Sun Hui Sun Yingying Wang |
| author_sort | Yuchuan Li |
| collection | DOAJ |
| description | The larynx of children and adolescents is still in the developmental phase and the anatomical structure is still very small and sensitive. The higher malignancy and faster progression of some paediatric thyroid cancers make surgery more difficult. Intraoperative neuromonitoring (IONM) is frequently used in thyroid surgery as an effective means of securing the recurrent laryngeal nerve (RLN). Little information is available on the clinical efficacy of IONM in paediatric surgery. In addition, classic IONM techniques such as reinforced tracheal tube models with integrated surface electrodes are not standardised for children and adolescents. The use of innovative devices such as laryngeal masks with surface electrodes and thyroid cartilage receiving electrodes could replace monitoring tubes as a new form of IONM. Tracheal intubation in children needs to be performed by a highly experienced anaesthetist. The continued maturation of AI technology could be attempted in the future in conjunction with IONM to further reduce RLN injuries in children and adolescents. This article describes the anatomical features of the paediatric larynx, which differ from those of adults, and the advantages and shortcomings of IONM techniques for thyroid surgery in this population. The use of IONM in paediatric surgery is a complex technique and should be performed by experienced thyroid surgeons with in-depth IONM training. The use of IONM should be standardised within the clinical parameters of children. |
| format | Article |
| id | doaj-art-1ffad93d0b9d48f19fef6e1bbf076485 |
| institution | Kabale University |
| issn | 1664-2392 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj-art-1ffad93d0b9d48f19fef6e1bbf0764852025-01-30T05:10:10ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-01-011510.3389/fendo.2024.14552171455217Paradigms of intraoperative neuromonitoring in paediatric thyroid surgeryYuchuan Li0Chunhai Zhang1Yi Zhang2Gianlorenzo Dionigi3Gianlorenzo Dionigi4Yishen Zhao5Hui Sun6Hui Sun7Yingying Wang8Department of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin University, Changchun, ChinaDepartment of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin University, Changchun, ChinaDepartment of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin University, Changchun, ChinaDivision of Surgery, Istituto Auxologico Italiano IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Milan, ItalyDepartment of Pathophysiology and Transplantation, University of Milan, Milan, ItalyDepartment of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin University, Changchun, ChinaDepartment of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin University, Changchun, ChinaJilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun, ChinaDepartment of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin University, Changchun, ChinaThe larynx of children and adolescents is still in the developmental phase and the anatomical structure is still very small and sensitive. The higher malignancy and faster progression of some paediatric thyroid cancers make surgery more difficult. Intraoperative neuromonitoring (IONM) is frequently used in thyroid surgery as an effective means of securing the recurrent laryngeal nerve (RLN). Little information is available on the clinical efficacy of IONM in paediatric surgery. In addition, classic IONM techniques such as reinforced tracheal tube models with integrated surface electrodes are not standardised for children and adolescents. The use of innovative devices such as laryngeal masks with surface electrodes and thyroid cartilage receiving electrodes could replace monitoring tubes as a new form of IONM. Tracheal intubation in children needs to be performed by a highly experienced anaesthetist. The continued maturation of AI technology could be attempted in the future in conjunction with IONM to further reduce RLN injuries in children and adolescents. This article describes the anatomical features of the paediatric larynx, which differ from those of adults, and the advantages and shortcomings of IONM techniques for thyroid surgery in this population. The use of IONM in paediatric surgery is a complex technique and should be performed by experienced thyroid surgeons with in-depth IONM training. The use of IONM should be standardised within the clinical parameters of children.https://www.frontiersin.org/articles/10.3389/fendo.2024.1455217/fullchildrenpaediatricsinfantadolescentthyroid glandrecurrent laryngeal nerve |
| spellingShingle | Yuchuan Li Chunhai Zhang Yi Zhang Gianlorenzo Dionigi Gianlorenzo Dionigi Yishen Zhao Hui Sun Hui Sun Yingying Wang Paradigms of intraoperative neuromonitoring in paediatric thyroid surgery Frontiers in Endocrinology children paediatrics infant adolescent thyroid gland recurrent laryngeal nerve |
| title | Paradigms of intraoperative neuromonitoring in paediatric thyroid surgery |
| title_full | Paradigms of intraoperative neuromonitoring in paediatric thyroid surgery |
| title_fullStr | Paradigms of intraoperative neuromonitoring in paediatric thyroid surgery |
| title_full_unstemmed | Paradigms of intraoperative neuromonitoring in paediatric thyroid surgery |
| title_short | Paradigms of intraoperative neuromonitoring in paediatric thyroid surgery |
| title_sort | paradigms of intraoperative neuromonitoring in paediatric thyroid surgery |
| topic | children paediatrics infant adolescent thyroid gland recurrent laryngeal nerve |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2024.1455217/full |
| work_keys_str_mv | AT yuchuanli paradigmsofintraoperativeneuromonitoringinpaediatricthyroidsurgery AT chunhaizhang paradigmsofintraoperativeneuromonitoringinpaediatricthyroidsurgery AT yizhang paradigmsofintraoperativeneuromonitoringinpaediatricthyroidsurgery AT gianlorenzodionigi paradigmsofintraoperativeneuromonitoringinpaediatricthyroidsurgery AT gianlorenzodionigi paradigmsofintraoperativeneuromonitoringinpaediatricthyroidsurgery AT yishenzhao paradigmsofintraoperativeneuromonitoringinpaediatricthyroidsurgery AT huisun paradigmsofintraoperativeneuromonitoringinpaediatricthyroidsurgery AT huisun paradigmsofintraoperativeneuromonitoringinpaediatricthyroidsurgery AT yingyingwang paradigmsofintraoperativeneuromonitoringinpaediatricthyroidsurgery |