Editing Thyroidectomy (section)

== Pre-op: ==

* Cord check if:
** Total thyroidectomy
** Completion thyroidectomy
** Pt symptomatic (voice)
** Thyroidectomy for cancer
* Biochemical assessment of     thyroid and parathyroid function
** If hyperthyroidism is      present, attempt to render euthyroid by time of operation
* Appropriate imaging studies     +/- biopsy
* Nerve monitor
** Electrical stimulator      current delivered to RLN (intermittent monitoring - more common) or vagus      (continuous monitoring), which leads to electromyographic signal at the      vocal cord detected by contact electrodes embedded on the surface of the      ETT
** Multiple studies have failed      to demonstrate a significant benefit in reducing RLN injury, including      2019 Cochrane review and 2022 meta-analysis
** Technique (intermittent)
*** Place probes at start of       case
*** Visual identification and       direct stimulation of RLN
*** Final reconfirmation of       intact RLN after completion
*** Can be useful to confirm       normal function of RLN before proceeding to the other side in a total       thyroidectomy