European Society of Endocrine Surgeons (ESES) consensus statement on standardization and research requirements for intraoperative nerve monitoring in endocrine surgery.

BACKGROUND: Intraoperative nerve monitoring (IONM) is widely used in endocrine surgery, yet substantial heterogeneity exists in its documentation, interpretation, and reporting. This limits comparability across studies and hampers the evaluation of clinical outcomes. METHODS: A consensus process was conducted by the European Society of Endocrine Surgeons (ESES), combining a systematic literature review, analysis of Eurocrine® registry data, a survey among ESES members, and a structured Delphi consensus process. RESULTS: Considerable variability was identified in monitoring techniques, signal interpretation, and outcome reporting. Key areas requiring standardization include the definition of loss of signal, documentation of neuromonitoring parameters, reporting of technical settings, and objective assessment of vocal cord function. Based on these findings, a set of consensus statements was developed to define minimum requirements for IONM research and reporting. CONCLUSION: This consensus statement provides a structured framework to improve standardization, data quality, and comparability in IONM research. Adoption of the recommendations may facilitate more robust evaluation of clinical outcomes and support future evidence generation in endocrine surgery.