Comparison of the Thyroid Cartilage Needle Electrode and the Endotracheal Tube Electrode During Monitoring of the External Branch of the Superior Laryngeal Nerve

Project no. 23954 · Status: Kapanmış · 2022

Summary

Background and Aim: Thyroid cartilage needle electrodes (NE) are an effective and safe recording side technique for intraoperative neuromonitoring. However, incomplete contact with the vocal cords of the electrodes of the endotracheal tube may hinder an optimal outcome and even result in an inability to obtain an EMG wave while neuromonitoring the external branch of the superior laryngeal nerve (EBSLN). Therefore, this study aims to compare NE and endotracheal tube electrode (ETE) recordings during EBSLN monitoring. Methods: Twenty-six consecutive patients undergoing total thyroidectomy were included in the study. Intraoperative neuromonitoring was performed simultaneously with both NE and ETE. Pre-resection (V1, R1, S1) and post-resection (V2, R2, S2) amplitudes and latencies were recorded for both types of electrodes. Mann-Whitney-U test was used for statistical analysis. Results: Twenty-one women and five men were included, and 52 nerves at risk were evaluated in the study. Mean amplitudes for right S1 (314 vs. 168 µV, p= 0.009), for right S2 (428 vs. 161 µV, p: 0.001); for left S1 (346 vs. 229 µV, p: 0.017) and left S2 (413 vs. 229 µV, p: 0.009) were statistically higher for the NE group. All amplitudes obtained with NE, except on the left for V1, R1, V2, and R2, were statistically higher than those obtained with ETE. There was no loss of signal or vocal cord palsy in the patients. None of the patients suffered from signal loss. There were no needle-related complications. Conclusion: EBSLN monitoring with NE is a safe and cheap alternative to ETE. With NE, higher amplitudes were obtained.

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