We describe a novel technique using double electrode pads for intraoperative neuromonitoring of the recurrent laryngeal nerve. This is a novel setup of intraoperative neuromonitoring that helps protect against faulty readings due to tube migration during surgery and allows for the recording of “side-specific” recurrent laryngeal nerve information. This method has not been previously described in the literature. This original approach to neuromonitoring helps guard against tube migration, simplifies the intubation process, allows for the acquisition of side-specific information, and is less expensive than use of commercially available integrated endotracheal tubes.
HermannMHellebartCFreissmuthM. Neuromonitoring in thyroid surgery: Prospective evaluation of intraoperative electrophysiological responses for the prediction of recurrent laryngeal nerve injury. Ann Surg2004;240:9–17.
2.
ReadyARBarnesAD. Complications of thyroidectomy. Br J Surg1994;81:1555–6.
3.
HermannMAlkGRokaRGlaserKFreissmuthM. Laryngeal recurrent nerve injury in surgery for benign thyroid diseases: Effect of nerve dissection and impact of individual surgeon in more than 27,000 nerves at risk. Ann Surg2002;235:261–8.
4.
ShankarKBPosnerMMooreFDJrO'RourkeN. Laryngeal nerve monitoring during thyroid surgery in pregnancy. J Clin Anesth2005;17:369–71.
5.
EilseDW. Complications in head and neck surgery. St Louis, Mo: Mosby, 1993:423–36.
6.
ChaudharyIASamiullahMasoodRMajroohMAMallhiAA. Recurrent laryngeal nerve injury: An experience with 310 thyroidectomies. J Ayub Med Coll Abbottabad2007;19:46–50.
7.
AytacBKaramercanA. Recurrent laryngeal nerve injury and preservation in thyroidectomy. Saudi Med J2005;26:1746–9.
8.
HemmerlingTMSchmidtJBosertCJacobiKEKleinP. Intraoperative monitoring of the recurrent laryngeal nerve in 151 consecutive patients undergoing thyroid surgery. Anesth Analg2001;93:396–409.
9.
SheddDPBurgetGC. Identification of the recurrent laryngeal nerve. Arch Surg1966;92:861–4.
10.
FlisbergKLindholmT. Electrical stimulation of the human recurrent laryngeal nerve during thyroid operation. Acta OtolaryngolSuppl1970;263:63–7.
11.
TschoppKPGottardoC. Comparison of various methods of electromyographic monitoring of the recurrent laryngeal nerve in thyroid surgery. Ann Otol Rhinol Laryngol2002;111:811–6.
12.
JacobsINFinkelRS. Laryngeal electromyography in the management of vocal cord mobility problems in children. Laryngoscope2002;112:1243–8.
13.
JohnsonSGoldenbergD. Intraoperative monitoring of the recurrent laryngeal nerve during revision thyroid surgery. Otolaryngol Clin North Am2008;41:1147–54,ix.
14.
PearlmanRCIsleyMRRubenGD. Intraoperative monitoring of the recurrent laryngeal nerve using acoustic, free-run, and evoked electromyography. J Clin Neurophysiol2005;22:148–52.
