Hyoung Shin Lee1, Jungho Oh2, Sung Won Kim1, Yeong Wook Jeong1, Che-Wei Wu3, Feng-Yu Chiang3, Kang Dae Lee4. 1. Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, 34, Amnam-Dong, Seo-Gu, Busan, 602-715, Republic of Korea. 2. Department of Otolaryngology-Head and Neck Surgery, Haedong Hospital, Busan, Republic of Korea. 3. Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 TzYou 1st Road, Kaohsiung, Taiwan. 4. Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, 34, Amnam-Dong, Seo-Gu, Busan, 602-715, Republic of Korea. kdlee59@gmail.com.
Abstract
BACKGROUND: Alternative methods to overcome limitations of electromyogram (EMG) tube applied for intraoperative neuromonitoring (IONM) of recurrent laryngeal nerve (RLN) during thyroidectomy have been introduced. In this study, we evaluated the feasibility of adhesive skin electrodes for IONM of RLN in patients who underwent thyroidectomy. METHODS: A total of 39 nerves at risk were prospectively enrolled in this study. Twenty-five patients with papillary thyroid carcinoma, 3 patients with follicular neoplasm, and 2 patients with Graves' disease underwent thyroidectomy. All patients were intubated with EMG tube, and two disposable pre-gelled surface electrodes were attached to skin at both upper margins of thyroid cartilage. We followed the standard procedure of IONM, and the latency (msec) and amplitude (μV) of each signal were recorded prospectively. RESULTS: Intraoperative neuromonitoring using skin adhesive electrodes was successful in all nerves at risk. Amplitudes of the signals in IONM were significantly lower compared to those from EMG tube at each step of IONM, while no significant difference was identified in latency between two methods. Four nerves at risk (10.3%) showed loss of signal (<100 μV) during the steps of IONM from EMG tube, while all nerves at risk from adhesive skin electrodes showed acceptable biphasic EMG signal. CONCLUSION: We verified the usefulness of adhesive skin electrodes for IONM of RLN during thyroidectomy. Although lower amplitude remains the major limitation of this technique, adhesive skin electrodes may be considered an alternative method for IONM during thyroidectomy.
BACKGROUND: Alternative methods to overcome limitations of electromyogram (EMG) tube applied for intraoperative neuromonitoring (IONM) of recurrent laryngeal nerve (RLN) during thyroidectomy have been introduced. In this study, we evaluated the feasibility of adhesive skin electrodes for IONM of RLN in patients who underwent thyroidectomy. METHODS: A total of 39 nerves at risk were prospectively enrolled in this study. Twenty-five patients with papillary thyroid carcinoma, 3 patients with follicular neoplasm, and 2 patients with Graves' disease underwent thyroidectomy. All patients were intubated with EMG tube, and two disposable pre-gelled surface electrodes were attached to skin at both upper margins of thyroid cartilage. We followed the standard procedure of IONM, and the latency (msec) and amplitude (μV) of each signal were recorded prospectively. RESULTS: Intraoperative neuromonitoring using skin adhesive electrodes was successful in all nerves at risk. Amplitudes of the signals in IONM were significantly lower compared to those from EMG tube at each step of IONM, while no significant difference was identified in latency between two methods. Four nerves at risk (10.3%) showed loss of signal (<100 μV) during the steps of IONM from EMG tube, while all nerves at risk from adhesive skin electrodes showed acceptable biphasic EMG signal. CONCLUSION: We verified the usefulness of adhesive skin electrodes for IONM of RLN during thyroidectomy. Although lower amplitude remains the major limitation of this technique, adhesive skin electrodes may be considered an alternative method for IONM during thyroidectomy.
Authors: Gregory W Randolph; Henning Dralle; Hisham Abdullah; Marcin Barczynski; Rocco Bellantone; Michael Brauckhoff; Bruno Carnaille; Sergii Cherenko; Fen-Yu Chiang; Gianlorenzo Dionigi; Camille Finck; Dana Hartl; Dipti Kamani; Kerstin Lorenz; Paolo Miccolli; Radu Mihai; Akira Miyauchi; Lisa Orloff; Nancy Perrier; Manuel Duran Poveda; Anatoly Romanchishen; Jonathan Serpell; Antonio Sitges-Serra; Tod Sloan; Sam Van Slycke; Samuel Snyder; Hiroshi Takami; Erivelto Volpi; Gayle Woodson Journal: Laryngoscope Date: 2011-01 Impact factor: 3.325
Authors: Whitney Liddy; Bradley R Lawson; Samuel R Barber; Dipti Kamani; Mohamed Shama; Selen Soylu; Che Wei Wu; Feng-Yu Chiang; Joseph Scharpf; Marcin Barczynski; Henning Dralle; Sam Van Slycke; Rick Schneider; Gianlorenzo Dionigi; Gregory W Randolph Journal: Laryngoscope Date: 2018-11-12 Impact factor: 3.325