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Updated: May 26, 2026
Intra-Operative Neural Monitoring of Thyroid Surgery in a Porcine Model
Published on: February 11, 2019
Effect of Electromyography Findings of Traction-Related Signal Loss on Prognosis During Neuromonitored Thyroidectomy
Serkan Karaisli1, Selda Gucek Haciyanli1, Emine Ozlem Gur1
1Department of General Surgery, Izmir Kâtip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
Background:
Intraoperative neuromonitoring (IONM) is a reliable tool to detect electromyographic loss of signal (LOS). Here, we investigated the effect of electromyography features of traction-related LOS on prognosis.
Methods:
Thyroidectomy patients with a traction-related LOS were included. The cases were divided into four groups as follows: Type 1 LOS with no amplitude (0 μV) (Group 1), Type 1 LOS with low-amplitude (1-99 μV) (Group 2), Type 2 LOS with no amplitude (Group 3), and Type 2 LOS with low-amplitude (Group 4).
Results:
A total of 788 patients (1429 nerves) were analyzed. Traction-related LOS was found in 74 patients (9.4%) and 77 nerves (5.4%). Intraoperative recovery was observed in 21 (48.8%) nerves in Group 4, and significantly higher (p = 0.011). Vocal cord paralysis was less in Group 4 (p = 0.001).
Conclusions:
In traction-related injury, electromyography features may contribute to the decision-making process. Type 2 LOS with low-amplitude is associated with a high likelihood of intraoperative recovery, potentially reducing the need for staged thyroidectomy.
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