Abstract:

Aim: Intraoperative neuromonitoring using an endotracheal tube surface electrode has become the most widely used technique due to its safety and simplicity. Intraoperative neuromonitoring with an endotracheal tube surface electrode has some disadvantages, such as false positive loss of signal. Therefore, electrodes on the thyroid cartilage are an alternative means to assess the thyroarytenoid muscle and recurrent laryngeal nerve function. This study aims to evaluate and compare the EMG signals recorded simultaneously using thyroid cartilage needle electrodes and standard endotracheal tube surface electrodes during intermittent intraoperative neuromonitoring in thyroid and parathyroid surgery. Materials and Methods: In this study, the data of the first 21 thyroid and parathyroid surgeries, in which both thyroid cartilage needle electrodes and endotracheal tube surface electrodes were used together as the recording side of the intermittent intraoperative neuromonitoring system in a single center, and EMG signals were recorded simultaneously, were analyzed retrospectively. Results: Overall, EMG amplitudes recorded from thyroid cartilage needle electrodes on both the right and left sides were significantly higher than those recorded from endotracheal tube surface electrodes at each step (V1-R1-R2-V2) (p<0.05 at all stimulation steps) Conclusion: Although the endotracheal tube surface electrodes are generally used for intraoperative neuromonitoring during thyroid and parathyroid surgery and are the recording-side method recommended by the International Neural Monitoring Study Group, the use of thyroid cartilage needle electrodes is an inexpensive, easy, and efficient alternative.

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