Future directions of neural monitoring in thyroid surgery

Intraoperative nerve monitoring is a well validated technology for use in thyroid surgery. Intermittent intraoperative nerve monitoring is commonly used. Unfortunately, it helps detect injury only after it occurs limiting its usefulness. Continuous intraoperative nerve monitoring appears to be the emerging technology which has the ability to overcome this disadvantage. In this review, we discuss the utility of continuous nerve monitoring and its application in open and remote access thyroidectomy and the role of surgeon’s role in the use of these new technologies.