The application of intraoperative neuromonitoring in lateral neck dissections for thyroid cancers

Neck dissections play an essential role in the management of thyroid cancer, it involves resection of the metastatic lymph nodes from levels II to V and often relating to important anatomical structures such as the motor branch of the vagus nerve (VN), spinal accessory nerve (SAN), hypoglossal nerve (HN), mandibular marginal nerve (MMN), phrenic nerve (PN) and brachial plexus (BP). Intraoperative neuromonitoring (IONM) of these motor nerves is relatively rare, however, it offers a potential way of protecting nerve integrity and reducing surgical risks in difficult cases. This review article will introduce the recent progress of IONM of six vulnerable motor nerves in lateral neck dissections (LNDs) for thyroid cancers.