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Guillermo Estébanez-Peláez
Universidad de Salamanca. Facultad de Medicina. Departamento de Cirugía. Hospital Universitario de Salamanca. Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello. IBSAL.
España
https://orcid.org/0000-0003-1122-2701
José Luis Pardal-Refoyo
Hospital Universitario de Salamanca. IBSAL, Instituto de Investigación Biomédica de Salamanca.Universidad de Salamanca
España
https://orcid.org/0000-0002-7462-1606
Biografía
Enrique González-Sánchez
Universidad de Salamanca. Facultad de Medicina. Departamento de Cirugía. Hospital Universitario de Salamanca. Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello. IBSAL.
España
https://orcid.org/0000-0003-4764-8907
Sofía Ferreira-Cendón
Universidad de Salamanca. Facultad de Medicina. Departamento de Cirugía. Hospital Universitario de Salamanca. Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello. IBSAL
España
Online Publicación continua / Continuous Publication, Artículo de revisión, Páginas e28102
DOI: https://doi.org/10.14201/orl.28102
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Resumen

Introducción y objetivo: La parálisis bilateral del nervio laríngeo recurrente (PBNLR) es una complicación con gran morbimortalidad en la cirugía de tiroides, aunque infrecuente. La identificación visual del nervio laríngeo recurrente (NLR) continúa siendo el patrón oro en el manejo. El objetivo es evaluar si la neuromonitorización intraoperatoria (NMIO) reduce el riesgo de PBNLR durante TT (tiroidectomía total), mediante revisión sistemática y metanálisis. Método: Revisión sistemática de artículos que incluían series de TT con y sin NMIO para la identificación del NLR, sin restricción de fecha o idioma en PubMed, BVS, Cochrane, Clinicaltrials y WoS. Se evaluó la prevalencia de PBNLR. Se realizó estudio descriptivo de las variables incluidas y metanálisis según modelo de efectos aleatorios. Resultados: Se seleccionaron 45 estudios, y se analizaron dos subgrupos: series retrospectivas (31 estudios) y series prospectivas (14 estudios); con un total de 197161 pacientes. Las series prospectivas resultaron homogéneas y con bajo sesgo de publicación, con un total de 11149 pacientes. En los estudios prospectivos, la diferencia observada del riesgo de PBNLR con y sin NMIO equivale a una reducción absoluta del riesgo (RAR) del 2.1‰ y un número necesario de técnica para realizar (NNT) de 487.15. Conclusiones: La NMIO aporta una reducción del riesgo de PBNLR.
 

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