Feasibility of Intraoperative Neuromonitoring During Thyroid Surgery Using Transcartilage Surface Recording Electrodes

• DOI: 10.1089/thy.2017.0680
• Publication Date: 2018-09-26T08:12:02Z
• Authors: Che-Wei Wu; Feng-Yu Chiang; Gregory W. Randolph; Gianlorenzo Dionigi; Hoon Yub Kim; Yi-Chu Lin; Hui-Chun Chen; Hsiu-Ya Chen; Dipti Kamani; Tsung-Yi Tsai; I-Cheng Lu; Pi-Ying Chang
• Keywords: Thyroid cartilage

Intraoperative neural monitoring (IONM) has gained widespread acceptance as an adjunct to the gold standard of visual identification recurrent laryngeal nerve (RLN) during thyroid surgery. Currently, electromyography (EMG) recording IONM is almost always performed using endotracheal tube (ETT) surface electrodes placed adjacent vocal folds originating from inner cartilage (TC). Therefore, it was hypothesized that on outer TC should enable access EMG response IONM. The aim this experimental study evaluate feasibility transcartilage approach for IONM.A porcine model (12 pigs and 24 RLN sides) with well established applicability in research used experiments. Both ETT adhesive pre-gelled were Electrically evoked signals detected by both electrode types recorded analyzed. changes tracheal displacement traction injury compared.Both typical waveforms a 1 mA stimulus current applied sides RLNs vagus nerves (VNs). Under stimulation, mean amplitudes 973 ± 79 μV 695 150 μV, respectively. VN 841 163 607 162 When upward trachea experimentally induced, showed less variation compared electrodes. stress accurately pattern progressively degrading amplitude gradual recovery after release traction.This confirms animal model. However, before practical application clinical surgery, further studies are needed improve designs optimizing their shapes sizes, increasing stability sensitivity.