Evidencia de la aplicabilidad de la neuromonitorización intermitente en cirugía de tiroides

  • Álvaro Sanabria Universidad de Antioquia
Palabras clave: glándula tiroides, tiroidectomía, nervio laríngeo recurrente, conducción nerviosa, monitorización intraoperatorio, factores de riesgo

Resumen

La tiroidectomía es la cirugía cervical más frecuente, con poca frecuencia de complicaciones. La frecuencia de lesión definitiva del nervio laríngeo recurrente es menor de 1 %, la de hipoparatiroidismo definitivo es de 1 a 2 % y la de hematoma cervical es de 0,5 %. La frecuencia de la lesión bilateral del nervio laríngeo recurrente que obliga a una traqueostomía, es inferior al 0,2 %. Desde hace más de una década aparecieron reportes del uso de la neuromonitorización intermitente, como una estrategia para disminuir aún más el riesgo de lesión del nervio laríngeo recurrente y del laríngeo superior. El objetivo de esta revisión es exponer la información disponible en pro o en contra del uso rutinario de la neuromonitorización intermitente en la cirugía de tiroides. En cinco de las seis revisiones sistemáticas, llegan a la conclusión de que no existen datos que demuestren que las lesiones definitivas del nervio laríngeo recurrente o el laríngeo superior, disminuyan con el uso rutinario de la neuromonitorización. La mayoría de los autores sugieren que los pacientes de alto riesgo de lesión del nervio serían los más beneficiados, pero la definición de alto riesgo es bastante heterogénea e indefinida. El uso del monitor ayuda poco en la toma de decisiones, específicamente cuando se pierde la señal, que es el objetivo con el cual se usa. Tampoco existen datos que demuestren que el uso del neuromonitor disminuya las demandas médico-legales.

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Biografía del autor/a

Álvaro Sanabria , Universidad de Antioquia

MD, MSc, PhD, cirujano de Cabeza y Cuello, Hospital Pablo Tobón Uribe; profesor asociado, Departamento de Cirugía, Universidad de Antioquia, Medellín, Colombia

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Publicado
2015-01-01
Cómo citar
(1)
Sanabria , Álvaro. Evidencia De La Aplicabilidad De La neuromonitorización Intermitente En cirugía De Tiroides. Rev Colomb Cir 2015, 30, 220-229.
Sección
Artículo de Revisión

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