What is the learning curve for intraoperative neuromonitoring in thyroid surgery?

This is the first series of thyroidectomies with standardized IONM technique performed in Italy. Neuromonitoring was effective in providing identification and function of laryngeal nerves. IONM successful rates were affected considerably by the extent of surgical and anaesthesiological experiences, starting with relatively low rates in the beginner group and then increasing. We assessed the learning curve: improved operative variables and safe technique were seen in about 50 patients.