The evolution and progress of anesthesia for intraoperative neuromonitoring during thyroid surgery

Nowadays thyroid surgery is the widely endocrine procedures performed worldwide. Since ancient times to 21th century the clinicians developed a lot of researches to reduce complications related to thyroid gland surgery. The postoperative challenges are haematoma, infections, hypocalcemia, tracheal injury and recurrent laryngeal nerve injury. The progress in technology with haemostatic instrument and the standardization of surgical technique reduced surgical related complications, while the introduction of intraoperative neuromonitoring (IONM) permitted to identify nerves and to preserve the functional activity of vocal cords avoiding postoperative complications such as dysphonia and vocal cords palsy. In this manuscript, we discuss the anesthesiological perspective about IONM evolution during thyroid surgery.