The Laryngoscope
October 7, 2026 · via Europe PMC
Video Laryngeal Mask Airway for Visual Recurrent Laryngeal Nerve Monitoring in Thyroid Surgery.
Liu F, Huang J, Chen X, +6 more, Wang G.
AI summary — for doctors, generated from the abstract only
A video flexible laryngeal mask airway allowed ventilation with direct visual recurrent laryngeal nerve monitoring in most thyroid surgery patients in this exploratory study.
What was studied
Prospective single-arm study of 104 consecutive thyroid surgery patients, assessing successful ventilation with RLN monitoring, diagnostic performance of visual monitoring and perioperative respiratory events.
Key findings
- Effective ventilation with RLN monitoring in 98 of 104 patients (94.2%); 6 (5.8%) converted to intubation, 2 (1.9%) during surgery
- Loss of signal occurred in 7 of 137 monitored nerves (5.1%) and correlated with transient postoperative vocal fold palsy (observed sensitivity and specificity 100%, with wide CIs)
- Transient ventilatory disturbances included elevated airway pressure (21.2%), reflex laryngospasm (8.7%) and air leakage (1.9%), all resolved with simple measures
Clinical relevance
May offer an alternative approach to RLN monitoring in carefully selected patients, if confirmed.
Who should care
Limitations
Single-arm, no comparator, few events so diagnostic estimates are imprecise; authors call findings hypothesis-generating (level of evidence 4).
Feasible in this series, but needs comparative validation.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objective
To evaluate the feasibility of a video flexible laryngeal mask airway (VFLMA) for simultaneous ventilation and direct visual RLN monitoring during thyroid surgery.
Methods
This prospective single-arm study enrolled 104 consecutive patients undergoing thyroid surgery, in whom the VFLMA provided real-time glottic views after induction. The primary outcome was successful ventilation with RLN monitoring. Secondary outcomes included diagnostic performance of visual RLN monitoring (vocal cord movement upon stimulation) and perioperative respiratory adverse events.
Results
Effective ventilation with RLN monitoring was achieved in 98 of 104 patients (94.2%). Six patients (5.8%) required conversion to endotracheal intubation with only 2 (1.9%) occurring during surgery. Among 137 monitored RLNs, loss of signal occurred in 7 (5.1%) and correlated with transient postoperative vocal fold palsy; observed sensitivity, specificity, and predictive values were 100% (95% CIs wide due to few events). Transient ventilatory disturbances occurred in 21.2% (elevated airway pressure), 8.7% (reflex laryngospasm), and 1.9% (transient air leakage) on ITT analysis (n = 104), all resolved with simple measures. Postoperative throat pain and odynophagia were mild and resolved within 1 week in most patients.
Conclusions
In this exploratory feasibility study, the VFLMA enabled direct visual RLN monitoring during thyroid surgery with an acceptable ventilation success rate. These preliminary findings are hypothesis-generating and require validation in comparative studies. With appropriate patient selection, the VFLMA may offer an alternative approach for RLN monitoring.
Trial registration
The study was registered at www.chictr.org.cn (Identifier: ChiCTR2500105012).
Level of evidence: 4
DOI
10.1002/lary.70973
PMID
42844016
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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