Interpretation of intraoperative neuromonitoring during thyroid surgery from INMSG experts

In recent years, there has been some continuous improvement of intraoperative neuromonitoring (IONM) during thyroid surgery. From fast positioning and precisely dissociating nerves, to real-time monitoring neural functions and warning of early damage, to analysis of the mechanism of neural injury, IONM has been an effective way to protect recurrent laryngeal nerve (RLN). What’s the importance of IONM? Should we choose continuous intraoperative neuromonitoring (CIONM) or intermittent intraoperative neuromonitoring (IIONM)? Are there any updates in the anatomy of superior laryngeal nerve (SLN), RLN and vagus nerve (VN)? How to deal with the problems during neural monitoring?