Practice Patterns and Factors Associated with Intraoperative Nerve Monitoring in Endocrine Surgery

Among 9,813 patients who underwent parathyroidectomy, intraoperative nerve monitoring was used in 49% of cases. There was a significant increase in parathyroidectomies with intraoperative nerve monitoring from 2014 to 2018, followed by a plateau. Vocal cord dysfunction after parathyroidectomy was not associated with intraoperative nerve monitoring. Surgeons who routinely used intraoperative nerve monitoring during thyroidectomy were more likely to use it during parathyroidectomy. Factors associated with intraoperative nerve monitoring during parathyroidectomy included reoperation, secondary/tertiary hyperparathyroidism, multiglandular disease, and non-localized disease. Further research is needed to identify the patients who may benefit most from intraoperative nerve monitoring in parathyroidectomy.