Low-Current Stimulation for Recurrent Laryngeal Nerve Protection During Thyroid Surgery

Clinical Utility of Low-Current Stimulation for Recurrent Laryngeal Nerve Protection During Thyroid Surgery: A Single-Center Prospective Randomized Interventional Study

This single-center prospective randomized interventional study evaluated whether intraoperative low-current stimulation could assist recurrent laryngeal nerve localization and reduce temporary recurrent laryngeal nerve injury during thyroid surgery.

Study Overview

Detailed Description

A total of 150 patients undergoing thyroid surgery at the Second Affiliated Hospital of Kunming Medical University were randomly allocated in a 1:1:1 ratio to conventional anatomical identification, 3 mA low-current stimulation, or 5 mA low-current stimulation. All participants underwent preoperative and postoperative electronic laryngoscopy. The primary outcome was temporary recurrent laryngeal nerve injury. Secondary outcomes included permanent recurrent laryngeal nerve injury, operative duration, intraoperative blood loss, postoperative hospital stay, and stimulation-related adverse events.

Study Type

Interventional

Enrollment (Actual)

150

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Yunnan
      • Kunming, Yunnan, China, 650000
        • The Second Affiliated Hospital Of Kunming Medical University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Patients scheduled for thyroid surgery.
  • No history of prior thyroid or neck surgery.
  • Normal bilateral vocal cord mobility on preoperative electronic laryngoscopy.
  • Written informed consent provided before enrollment.

Exclusion Criteria:

  • Preoperative recurrent laryngeal nerve dysfunction.
  • Previous neck surgery.
  • Incomplete clinical data.
  • Severe comorbidities precluding standardized perioperative assessment.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Control group
Participants underwent conventional anatomical identification and preservation of the recurrent laryngeal nerve during thyroid surgery.
Experimental: 3 mA group
Participants underwent 3 mA low-current stimulation-assisted recurrent laryngeal nerve identification in addition to conventional anatomical identification.
Low-current stimulation at 3 mA was used as an adjunct to anatomical recurrent laryngeal nerve identification. Response was judged according to visible or palpable laryngeal twitch.
Experimental: 5 mA group
Participants underwent 5 mA low-current stimulation-assisted recurrent laryngeal nerve identification in addition to conventional anatomical identification.
Low-current stimulation at 5 mA was used as an adjunct to anatomical recurrent laryngeal nerve identification. Response was judged according to visible or palpable laryngeal twitch.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Participants With Permanent Recurrent Laryngeal Nerve Injury Confirmed by Electronic Laryngoscopy
Time Frame: 6 months after surgery
Permanent recurrent laryngeal nerve injury is defined as unilateral or bilateral vocal cord paresis or paralysis detected after surgery and still present at the 6-month postoperative assessment, as confirmed by electronic laryngoscopy. The number of participants meeting this definition will be reported.
6 months after surgery

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Participants With Vocal Cord Paresis or Paralysis Persisting at 6 Months, as Assessed by Electronic Laryngoscopy
Time Frame: 6 months after surgery
Permanent recurrent laryngeal nerve injury is defined as unilateral or bilateral vocal cord paresis or paralysis detected after surgery and still present at the 6-month postoperative assessment, as confirmed by electronic laryngoscopy. The number of participants meeting this definition will be reported.
6 months after surgery
Total Operative Duration in Minutes
Time Frame: Intraoperative period
Total operative duration will be measured in minutes from the initial skin incision to completion of skin closure.
Intraoperative period
Intraoperative blood loss
Time Frame: Intraoperative period
Estimated intraoperative blood loss measured in milliliters.
Intraoperative period
Duration of Postoperative Hospital Stay in Days
Time Frame: From the date of surgery until hospital discharge, assessed up to 30 days after surgery
Postoperative hospital stay will be calculated as the number of calendar days from the date of surgery to the date of hospital discharge.
From the date of surgery until hospital discharge, assessed up to 30 days after surgery
Number of Participants With Stimulation-Related Adverse Events
Time Frame: From initiation of intraoperative nerve stimulation through 30 days after surgery
The number of participants experiencing at least one stimulation-related adverse event will be reported. Stimulation-related adverse events include suspected thermal injury, arrhythmia, hemodynamic instability, muscle burn, overstimulation, or suspected false-negative nerve localization, as documented in the intraoperative and postoperative medical records.
From initiation of intraoperative nerve stimulation through 30 days after surgery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Siqi Li, The Second Affiliated Hospital Of Kunming Medical University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 1, 2024

Primary Completion (Actual)

March 1, 2025

Study Completion (Actual)

March 1, 2025

Study Registration Dates

First Submitted

June 26, 2026

First Submitted That Met QC Criteria

July 10, 2026

First Posted (Actual)

July 16, 2026

Study Record Updates

Last Update Posted (Actual)

July 16, 2026

Last Update Submitted That Met QC Criteria

July 10, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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