Ear, nose, and throat
Head and neck surgery
Find education, evidence, and innovation
NIM Vital™ nerve monitoring system
The next generation in nerve monitoring
Preserving laryngeal and facial nerve function and reducing the possibility of nerve palsy1 is key to preserving quality of life for your patients.2
The NIM Vital™ nerve monitoring system gives you a strategic advantage† and greater confidence when monitoring nerve function.‡3 It advances nerve monitoring to inform your surgical strategy1,4,5,6 so patients can continue living fully and feeling deeply.
See how the NIM Vital™ system pushes the boundaries of monitoring nerve function in head and neck surgery.
Education and training
NIM Vital™ NerveTrend™ EMG reporting: Case 1
Professor Barczyński, MD, PhD, presents a surgical case study using NIM Vital™ NerveTrend™ EMG reporting technology. (02:47)
NIM Vital™ NerveTrend™ EMG reporting: Case 2
Professor Barczyński, MD, PhD, presents a surgical case study using NIM Vital™ NerveTrend™ EMG reporting technology. (03:03)
PTeye™ parathyroid detection system
See professor Solorzano, MD, FACS, FSSO, discuss the PTeye™ parathyroid detection system. (06:56)
Clinical evidence
I-IONM
International neural monitoring study group guideline 2018 part I: staging bilateral thyroid surgery with monitoring loss of signal
C-IONM
Prediction of postoperative vocal fold function after intraoperative recovery of loss of signal
Parathyroid identification
A novel optical approach to intraoperative detection of parathyroid glands
Nerve monitoring FAQ
What is a nerve monitor?
Intraoperative nerve monitoring (IONM) is a technique used during surgery to monitor the condition of a patient’s nervous system throughout the surgical procedure. Monitoring the condition of the nervous system helps prevent damage to the spinal cord, brain, facial, or laryngeal nerves.
How does NIM monitor work?
NIM nerve monitoring electrodes are placed in the appropriate muscle locations in the patient for the procedure being performed. These electrodes are connected to the NIM nerve monitoring system, which continuously monitors EMG activity from muscles innervated by the affected nerve.
What is NIM thyroidectomy?
Visually identifying the RLN or VN can be difficult in areas with poor visibility, even with a detailed knowledge of anatomy and surgical skill. The NIM can be used to identify and assess the RLN and VN during dissection for valuable information that can reduce the risk of injury to the patient and give you added peace-of-mind.
Using the NIM and meticulous dissection of the upper thyroid pole improves EBSLN identification. As the EBSLN is at risk during thyroidectomy and can lead to voice morbidity, the NIM can aid identification of the EBSLN and provide a functional assessment of the EBSLN after thyroid resection.
Who can perform intraoperative monitoring?
While a full IONM team consisting of at least four members — an operating surgeon, an anesthesiologist, a neurophysiologist, and a medical technologist trained by a neurophysiologist — is usually necessary to perform IONM, a smaller team may suffice under limited circumstances.
† Compared to visualization alone.
‡ Compared to NIM-Response™ 3.0 system and NIM-Neuro™ 3.0 system.
- Dionigi G, Bacuzzi A, Boni L. The technique of intraoperative neuromonitoring in thyroid surgery. Surg Technol Int. 2010;19:25–37.
- Wilson JA, Deary IJ, Millar A, Mackenzie K. The quality of life impact of dysphonia. Clin Otolaryngol Allied Sci. 2002;27(3):179–182.
- Thomusch O, Sekulla C, Walls G, Machens A, Dralle H. Intraoperative neuromonitoring of surgery for benign goiter. Am J Surg. 2002;183(6):673-678.
- Dionigi G, Barczynski M, Chiang FY, et al. Why monitor the recurrent laryngeal nerve in thyroid surgery? J Endocrinol Invest. 2010;33(11):819–822.
- Randolph GW, Dralle H; International Intraoperative Monitoring Study Group, et al. Electrophysiologic recurrent laryngeal nerve monitoring during thyroid and parathyroid surgery: international standards guideline statement. Laryngoscope. 2011;121 Suppl 1:S1–16.
- Stopa M, Barczyński M. Prognostic value of intraoperative neural monitoring of the recurrent laryngeal nerve in thyroid surgery. Langenbecks Arch Surg. 2017;402(6):957–964.