EMG Tube Based Intraoperative Neuromonitoring in Thyroid Surgery

Thyroid surgery can cause many complications, but recurrent laryngeal nerve palsy is the most important. Therefore, many efforts have been tried to avoid recurrent laryngeal nerve palsy. Among them, intraoperative neuromonitoring (IONM) is one of the useful tools to find nerves and avoid nerve palsy during surgery. There are various methods, but the method of directly monitoring the movement of the vocal cords using an electromyography tube was introduced first. After that, a method of increasing the signal accuracy by using a pressure sensor and an accelerometer sensor was also introduced. In addition, a needle is directly pierced into the thyroid cartilage or an electrical signal is measured by attaching a sensor to the skin in front of the thyroid cartilage. Various methods of IONM are being tried and studied, and efforts to help find nerves through IONM are continuing. It is expected that overall surgical complications will be reduced by preserving nerves, avoiding changes in voice and swallowing disorders, and reducing the need for tracheostomy due to bilateral vocal cord palsy.