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Development of the Novel Intraoperative Neuromonitoring for Thyroid Surgery
Int J Thyroidol 2018;11(2):109-116
Published online November 30, 2018;  https://doi.org/10.11106/ijt.2018.11.2.109
© 2018 Korean Thyroid Association.

Eui Suk Sung1 and Byung Joo Lee2

Department of Otolaryngology-Head and Neck Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine1, Yangsan, Department of Otolaryngology-Head and Neck Surgery, Pusan National University Hospital, Pusan National University School of Medicine2, Busan, Korea
Correspondence to: Byung Joo Lee, MD, PhD, Department of Otolaryngology-Head and Neck Surgery, Pusan National University Hospital, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Korea
Tel: 82-51-240-7675, Fax: 82-51-246-8668, E-mail: voiceleebj@gmail.com
Received March 25, 2018; Revised July 4, 2018; Accepted July 27, 2018.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
It is very important to identify recurrent laryngeal nerve (RLN) and prevent RLN injury during thyroid surgery. The intraoperative neuromonitoring (IONM) for the prevention of RLN injury is a useful method because it can identify the location and status of RLN and predict postoperative vocal cord function easily. The IONM consists of a stimulating side that applies electrical stimulation to the nerve and a recording side that measures the surface electromyography (EMG) of the vocal cord muscle through electrode endotracheal tube. The nerve stimulator and surgical dissector are separate instruments. So, during IONM for the prevention of the RLN injury in conventional, endoscopic, or robotic thyroid surgery, repeated exchanging between surgical instruments and the nerve stimulator is inconvenient and time consuming. On the recording side, the accuracy of the electrode endotracheal tube which measures the EMG of the vocalis muscle can be affected by contact with between electrode and vocal fold and position change of patient. We would like to introduce recent several researches to overcome the current limitations of IONM.
Keywords : Thyroid surgery, Intraoperative neuromonitoring, Recurrent laryngeal nerve, Attachable nerve stimulator, Surface bio-pressure sensor


November 2018, 11 (2)