Head and neck surgery


Explore solutions for Medtronic ENT head and neck surgery solutions, including 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 NIM Vital 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.

NIM Vital™ NerveTrend™ EMG reporting: Case 2

Professor Barczyński, MD, PhD, presents a surgical case study using NIM Vital™ NerveTrend™ EMG reporting technology.

PTeye™ parathyroid detection system

See professor Solorzano, MD, FACS, FSSO, discuss PTeye™ parathyroid detection system.

Clinical evidence


International neural monitoring study group guideline 2018 part I: Staging bilateral thyroid surgery with monitoring loss of signal




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

NIM Vital monitor displaying nerve monitoring software

Nerve monitoring 

NIM Vital™ intraoperative nerve monitoring system

The NIM Vital™ system is an intraoperative EMG monitor that enables users to locate and confirm the integrity of nerves during surgical procedures.

A yellow and turquoise APS continuous monitoring electrode

Neuromonitoring accessories 

APS™ continuous monitoring electrodes

The Automatic Periodic Stimulation (APS™) continuous monitoring electrodes enable early detection and warning of a change in nerve function to prevent damage to the recurrent laryngeal nerve (RLN) during thyroid surgery.

Closeup of the PTeye parathyroid detection system on gray background

Parathyroid detection

PTeye™ parathyroid detection system

The PTeye™ system aids surgeons in the identification of parathyroid tissue by confirming parathyroid tissue real-time during thyroid and parathyroid surgery.

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.


NIM Vital nerve monitoring system shown on full cart.

Learn more about the NIM Vital™ nerve monitoring system.



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Compared to visualization alone.

Compared to NIM™ 3.0 Response and NIM™ 3.0 Neuro.


Dionigi G, et al. The technique of intraoperative neuromonitoring in thyroid surgery. Surg Technol Int. 2010;19:25–37


Wilson JA, Deary IJ, Miller A, et al. The quality of life impact of dysphonia. Clin Otolaryng 2002;27:179–82


Thomusch O, et al. Intraoperative neuromonitoring of surgery for benign goiter. Amer J Surg. 2002;183(6):673-8


Dionigi G, et al. Why monitor the recurrent laryngeal nerve in thyroid surgery? J Endocrinal Invest. 2010; 33: 819–822


Randolph GW and Dralle H with the International Intraoperative Monitoring Study Group. Electrophysiologic recurrent laryngeal nerve monitoring during thyroid and parathyroid surgery: international standards guideline statement. Laryngoscope 2011; 121:S1–S16


Stopa M. Prognostic value of intraoperative neural monitoring of the recurrent laryngeal nerve in thyroid surgery. Langenbecks Arch Surg (2017) 402:957–964