Transcricothyroid electromyographic monitoring of the recurrent laryngeal nerve.
OBJECTIVE
To determine the usefulness of intraoperative nerve monitoring using an electrode placed in the midline through the cricothyroid membrane.


METHODS
Retrospective records review.


METHODS
Patients of the otolaryngology department of our tertiary care academic medical center were identified if they had undergone either total thyroidectomy or total thyroid lobectomy accompanied by bilateral electromyographic (EMG) monitoring of the recurrent laryngeal nerve (RLN) between January 2007 and October 2007.


RESULTS
Forty-three patients were identified who had a total thyroidectomy or a total thyroid lobectomy. Nineteen of the 43 had intraoperative EMG monitoring of the RLN with placement of a single EMG electrode through the cricothyroid membrane; 11 had a thyroidectomy, and eight had a thyroid lobectomy. Overall, 30 at-risk nerves were stimulated with an EMG probe; 27 responded adequately and three (paralyzed before surgery) were unresponsive.


CONCLUSIONS
Central placement of an EMG electrode through the cricothyroid membrane into the thyroarytenoid musculature is a safe and reliable technique for bilateral monitoring of the RLN that facilitates evaluation of postoperative function.
Alon
Eran E
EE
Division of Otolaryngology-Head and Neck Surgery, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA.
Hinni
Michael L
ML
D000368:Aged; D004576:Electromyography; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control; D007431:Intraoperative Complications / Q000517:prevention & control*; D007821:Laryngeal Muscles; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D061226:Recurrent Laryngeal Nerve Injuries; D012189:Retrospective Studies; D013965:Thyroidectomy; D014826:Vocal Cord Paralysis / Q000517:prevention & control; D055815:Young Adult