Low-Current Stimulation for Recurrent Laryngeal Nerve Protection During Thyroid Surgery

Clinical Utility of Low-Current Stimulation for Recurrent Laryngeal Nerve Protection During Thyroid Surgery: A Single-Center Prospective Randomized Interventional Study

This single-center prospective randomized interventional study evaluated whether intraoperative low-current stimulation could assist recurrent laryngeal nerve localization and reduce temporary recurrent laryngeal nerve injury during thyroid surgery.

A total of 150 patients undergoing thyroid surgery at the Second Affiliated Hospital of Kunming Medical University were randomly allocated in a 1:1:1 ratio to conventional anatomical identification, 3 mA low-current stimulation, or 5 mA low-current stimulation. All participants underwent preoperative and postoperative electronic laryngoscopy. The primary outcome was temporary recurrent laryngeal nerve injury. Secondary outcomes included permanent recurrent laryngeal nerve injury, operative duration, intraoperative blood loss, postoperative hospital stay, and stimulation-related adverse events.

Inclusion Criteria:

• Patients scheduled for thyroid surgery.
• No history of prior thyroid or neck surgery.
• Normal bilateral vocal cord mobility on preoperative electronic laryngoscopy.
• Written informed consent provided before enrollment.

Exclusion Criteria:

• Preoperative recurrent laryngeal nerve dysfunction.
• Previous neck surgery.
• Incomplete clinical data.
• Severe comorbidities precluding standardized perioperative assessment.