Int J Thyroidol.  2022 Nov;15(2):110-115. 10.11106/ijt.2022.15.2.110.

Intraoperative Neuromonitoring of Recurrent Laryngeal Nerve Using Adhesive Skin Electrodes during Minimally Invasive Open Hemithyroidectomy

• Cheon YI
• Shin SC
• Seo MG
• Kwon HN
• Cho YJ
• Lee BJ

• KMID: 2536496
• DOI: http://doi.org/10.11106/ijt.2022.15.2.110

Abstract

Background
Intraoperative neuromonitoring (IONM) using adhesive skin electrodes has been reported to be useful method for preserving recurrent laryngeal nerve (RLN) in thyroid surgery. The aim of this study is to investigate the usefulness of IONM using adhesive skin electrodes in minimally invasive open hemithyroidectomy.
Materials and Methods
A retrospective study was conducted on 23 patients diagnosed with micropapillary thyroid carcinoma from May 2020 to August 2022 who underwent minimally invasive open hemithyroidectomy. Adhesive skin electrodes were attached to the skin in the area of the lateral border of the thyroid cartilage lamina. Hemithyroidectomy was performed by approaching between sternocleidomastoid and strap muscles, after a 3-4 cm horizontal skin incision. We collected the data regarding age, sex, mean amplitude and latency of evoked electromyogram (EMG) (V1, R1, R2, V2).
Results
The amplitude of EMG from vagus and RLN was successfully measured. The mean amplitude was measured as 239.2 μV for V1, 278.0 μV for R1, 362.1 μV for R2, and 307.0 μV for V2, respectively.
Conclusion
The monitoring using adhesive skin electrodes is good alternative method of IONM using EMG endotracheal tube for preserving RLN during minimally invasive open hemithyroidectomy.

Keyword

Thyroidectomy; Recurrent laryngeal nerve; Intraoperative neuromonitoring; Skin electrode

Figure

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  Fig. 1 Procedure of minimally invasive open hemithyroidectomy and setting of intraoperative neuromonitoring. (A) Attachment location of adhesive skin electrodes (lateral border of thyroid cartilage lamina). (B) Intraoperative approach. Dissection between sternocleidomastoid and strap muscles was performed.

Reference

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