Needle electrodes inserted in the thyroid cartilage may provide better neuromonitoring signals during thyroidectomy

In this interesting paper, authors used an animal model (Meishan piglets) to evaluate the utility of using needle electrodes inserted in the thyroid cartilage (TC), compared with endotracheal tube (ET) electrodes, for neuromonitoring during thyroid surgery with evaluation of electromyographic profile of the vagus and recurrent laryngeal nerves. First, various needle insertion depths and orientations were evaluated in nine areas of the TC to determine best potential locations for needles placement. Then, electromyographic profiles (amplitude and latency features) were recorded using TC and ET electrodes and were compared during intermittent and continuous monitoring. Interestingly, a previously published nerve traction injury model was also used to detect and compare electromyographic profiles obtained by the TC needle versus ET electrodes.