Intraoperative Neuromonitoring Using a Single Transcartilage Needle Electrode During Thyroidectomy.

Area of Science:

• Otolaryngology
• Surgical Neurology
• Medical Devices

Background:

• Transcartilage needle electrodes offer an alternative to electromyography (EMG) tube recording for intraoperative neuromonitoring (IONM) during thyroidectomy.
• Current methods require bilateral insertion and exposure of the thyroid cartilage lamina.

Purpose of the Study:

• To evaluate the feasibility of using a single ipsilateral transcartilage needle electrode for IONM during unilateral hemithyroidectomy.
• To assess the safety and efficacy of this minimally invasive approach.

Main Methods:

• Thirty-four patients undergoing unilateral thyroidectomy were included.
• A dual disposable needle electrode was inserted into the thyroid cartilage, with depth categorized as deep (≥5 mm) or superficial (<5 mm).
• IONM was performed using only the single needle electrode, without an EMG tube.

Main Results:

• Successful IONM was achieved in all nerves at risk, with stable EMG signal amplitudes and no signal loss.
• Superficial needle insertion (<5 mm) resulted in significantly lower EMG signal amplitudes.
• No postoperative vocal cord paralysis or complications related to the needle electrode were observed.

Conclusions:

• Single ipsilateral transcartilage needle electrode IONM is feasible and safe for unilateral hemithyroidectomy.
• This method provides an alternative to traditional techniques with the benefit of reduced thyroid cartilage exposure.