Intraoperative nerve monitoring is used routinely by a significant majority of head and neck surgeons in thyroid surgery and impacts on extent of surgery-Survey of the American Head and Neck Society.

BACKGROUND: The data on the advantages of intraoperative nerve monitoring (IONM) during thyroid surgeries is inconsistent. Our objective was to study the patterns of use of IONM in thyroid surgery among American Head and Neck Society (AHNS) members. METHOD: A web-based survey was e-mailed to all members of the AHNS. RESULTS: A total of 275 surgeons completed the survey. Seventy-two percent reported using IONM routinely. Routine use of IONM was associated with longer period in practice. Twenty-one percent only used IONM selectively in high-risk cases. Most surgeons would consider aborting the procedure in cases of loss of signal without continuing to the contralateral side. Finally, only 19% of surgeons attempt to identify the external branch of the superior laryngeal nerve (EBSLN). CONCLUSIONS: The majority of AHNS surgeons routinely use IONM during thyroid surgery as a real-time decision-making tool. However, IONM for preservation of the EBSLN is underutilized.