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A Thoughtful Approach to IONM Outcomes Reporting

  • Nerve Monitoring in Head and Neck Surgery (C Sinclair, Section Editor)
  • Published:
Current Otorhinolaryngology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To explore how the different types of intraoperative neuromonitoring (IONM)—namely intermittent (I-IONM) and continuous (C-IONM)—differ from each other and to examine how these differences can affect expected outcomes from IONM.

Recent Findings

Intraoperative neuromonitoring (IONM) is an important surgical tool for assessment of nerve functional status during surgical procedures where a particular nerve is at risk of injury. IONM has evolved especially in the thyroid/parathyroid surgical space. Accurate use of IONM is dependent on correct set-up of the monitoring equipment and on the surgeon’s implementation and responsiveness to the information provided by the equipment. I-IONM and C-IONM are complementary and together facilitate an unparalleled window into intraoperative neural functional integrity. Rate of nerve palsy is not the only outcome to consider when designing a study to define the utility of IONM in surgery. Other outcomes that are important to consider include alterations in surgical decision making based on IONM data including staged surgical approaches and enhanced localization abilities (especially important for I-IONM techniques); temporal course of a nerve injury (especially important for C-IONM); and changes in surgical technique over time induced by intraoperative nerve functional feedback (especially important for C-IONM).

Summary

The surgical team should be realistic about what they wish to achieve with IONM and choose the form IONM to be used based on these requirements.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Author information

Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, USA

    Catherine F. Sinclair

  2. Department of Otolaryngology Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, USA

    Greg W. Randolph

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  1. Catherine F. Sinclair
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  2. Greg W. Randolph
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by CF Sinclair and GW Randolph. The first draft of the manuscript was written by CF Sinclair, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Catherine F. Sinclair.

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Conflict of Interest

Dr Catherine F Sinclair is named as an inventor on a patent held by Mount Sinai Innovation Partners, filed on 12/23/2016, entitled “Improved Method and System for Assessing Laryngeal and Vagus Nerve Integrity in Patients Under General Anesthesia.” Dr Gregory W Randolph has no competing interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the author.

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CF Sinclair and GW Randolph hereby consent for publication of the content of this article by Current Otorhinolaryngology Reports.

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Sinclair, C.F., Randolph, G.W. A Thoughtful Approach to IONM Outcomes Reporting. Curr Otorhinolaryngol Rep 9, 341–344 (2021). https://doi.org/10.1007/s40136-021-00364-4

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  • DOI: https://doi.org/10.1007/s40136-021-00364-4

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