General Surgery Department, Izmir Democracy University Buca Seyfi Demirsoy Education and Research Hospital, Izmir, Turkey.
Division of Endocrine Surgery, Department of General Surgery, Ege University Hospital, Izmir, Turkey.
Updates Surg. 2024 Oct;76(6):2337-2342. doi: 10.1007/s13304-024-01982-5. Epub 2024 Sep 5.
During thyroidectomy, both needle electrodes (NE) and endotracheal tube electrodes (ETE) can be used. Incomplete contact of the endotracheal tube electrode with the vocal cords, endotracheal tube electrode may hinder an optimal outcome and even result in an inability to obtain an electromyography wave while neuromonitoring the external branch of the superior laryngeal nerve (EBSLN). There is no study that compares NE and ETE for EBSLN monitoring. Therefore, this study compares NE and ETE recordings during EBSLN monitoring. Twenty-six consecutive patients undergoing total thyroidectomy were included in this study. Intraoperative neuromonitoring was performed simultaneously with both NEs and ETEs. Pre-resection (V1, R1, and S1) and post-resection (V2, R2, and S2) amplitudes and latencies were recorded for both types of electrodes. The Mann-Whitney U test was used for statistical analysis. Twenty-one women and five men were included, and 52 nerves at risk were evaluated. The mean amplitudes for right S1 (314 vs. 168 µV, p = 0.009) and right S2 (428 vs. 161 µV, p: 0.001) and 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 using NEs, except on the left for V1, R1, V2, and R2, were statistically higher than those obtained using ETEs. There was no loss of signal or vocal cord palsy in the patients. There were no needle-related complications. EBSLN monitoring using NE is a safe alternative to ETE. With NE, higher amplitudes were obtained. Level of evidence: Level 3.
在甲状腺切除术期间，可以使用针状电极 (NE) 和气管内管电极 (ETE)。气管内管电极与声带接触不完全，可能会妨碍最佳结果，甚至导致在监测喉上神经外支 (EBSLN) 时无法获得肌电图波。没有研究比较 NE 和 ETE 用于 EBSLN 监测。因此，本研究比较了 EBSLN 监测中使用 NE 和 ETE 的记录。这项研究纳入了 26 例连续接受甲状腺全切除术的患者。术中神经监测同时使用 NE 和 ETE 进行。记录两种类型电极的术前 (V1、R1 和 S1) 和术后 (V2、R2 和 S2) 振幅和潜伏期。统计分析采用 Mann-Whitney U 检验。纳入 21 名女性和 5 名男性，共评估 52 条高危神经。右侧 S1（314 对 168µV，p=0.009）和右侧 S2（428 对 161µV，p=0.001）以及左侧 S1（346 对 229µV，p=0.017）和左侧 S2（413 对 229µV，p=0.009）的 NE 组平均振幅较高。NE 组获得的所有振幅，除左侧 V1、R1、V2 和 R2 外，均高于 ETE 组。所有患者均未出现信号丢失或声带麻痹。无针相关并发症。使用 NE 进行 EBSLN 监测是 ETE 的安全替代方法。使用 NE 可获得更高的振幅。证据水平：3 级。
