Table 1.

Standardized IONM procedures.

Procedures
L1 Pre-operative examination of VC function with laryngofiberscope
V1 Vagus nerve stimulation with 5-10 mA before thyroid dissection
R1 RLN stimulation with 3-5 mA at first RLN identification
(R2p)* RLN stimulation with 3-5 mA at the most proximal end after RLN dissection
(R2d)* RLN stimulation with 3-5 mA at the distal end near the laryngeal entry point
V2 Vagus nerve stimulation with 5-10 mA after resection of thyroid lobe
L2 Post-operative examination of VC function with laryngofiberscope

*RLN mapping with 1 mA if the amplitude reduction of R_2p/R_2d signals over 10% or LOS

IONM, intraoperative neuromonitoring; RLN, recurrent laryngeal nerve; VC, vocal cord.