Intraoperative Neuromonitoring System Using Needle and Skin Electrode during Thyroid Surgery

ABSTRACT

Intraoperative neuromonitorng (IONM) has gained wide acceptance as a useful adjunct in identifying and preserving of recurrent laryngeal nerve (RLN) during thyroid surgery. The electromyographic endotracheal tube (EMG-ETT) method is the most widely used and well-validated method for thyroid IONM; however, malpositioning of the tube is a critical shortcoming of the EMG-ETT method. This is the main reason for the low positive predictive value of IONM in thyroid surgery. Needle and skin electrodes can obtain EMG signal regardless of patient position and are easy to apply during surgery and is economical compared to EMG-ETT method. New IONM system using needle or skin electrodes would be an alternative method which can overcome shortcomings of EMG-ETT.