Electromyographic endotracheal tube placement during thyroid surgery in neuromonitoring of recurrent laryngeal nerve

Cheng Jing Tsai, Kuang Yi Tseng, Fuy Uan Wang, I. Cheng Lu, Hsun Mo Wang, Che Wei Wu, Hui Ching Chiang, Feng Yu Chiang

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Intraoperative neuromonitoring (IONM) is widely used in thyroid surgery. This study aimed to investigate the influence of neck extension on electromyographic (EMG) endotracheal tube displacement and to determine the necessity of routinely checking the final electrode position after the patient had been fully positioned. A consecutive 220 patients undergoing thyroidectomy were enrolled. All patients were intubated with the EMG endotracheal tube under direct laryngoscopy. The electrode position and tube displacement were routinely checked and measured by laryngofiberoscopy before and after patient positioning. The patients were divided into two groups. In Group I (n = 110), the EMG tube was taped and fixed to the right mouth angle before full neck extension. In Group II (n = 110), the EMG tube was disconnected from the circuit tube and was not taped until full neck extension. In all patients, we ensured that the final electrode position was the optimal position with laryngofiberoscopic examination. The tube displacement after neck extension ranged from 16 mm upward to 4 mm downward in Group I and from 12 mm upward to 5 mm downward in Group II. The rate of tube displacement greater than 10 mm was 12.7% in Group I and 3.6% in Group II. Successful monitoring was achieved in all patients after the final optimal position of electrodes was ensured routinely. The electrode position can be severely displaced after the patient has been fully positioned. Verification of ideal position of electrodes before the beginning of the operation is a necessary step to guarantee functional intraoperative neuromonitoring.

Original languageEnglish
Pages (from-to)96-101
Number of pages6
JournalKaohsiung Journal of Medical Sciences
Volume27
Issue number3
DOIs
Publication statusPublished - 2011 Mar 1

Fingerprint

Recurrent Laryngeal Nerve
Thyroid Gland
Electrodes
Neck
Patient Positioning
Laryngoscopy
Thyroidectomy
Mouth

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Tsai, Cheng Jing ; Tseng, Kuang Yi ; Wang, Fuy Uan ; Lu, I. Cheng ; Wang, Hsun Mo ; Wu, Che Wei ; Chiang, Hui Ching ; Chiang, Feng Yu. / Electromyographic endotracheal tube placement during thyroid surgery in neuromonitoring of recurrent laryngeal nerve. In: Kaohsiung Journal of Medical Sciences. 2011 ; Vol. 27, No. 3. pp. 96-101.
@article{0efefc0c6bb5476795ae65bead8905ec,
title = "Electromyographic endotracheal tube placement during thyroid surgery in neuromonitoring of recurrent laryngeal nerve",
abstract = "Intraoperative neuromonitoring (IONM) is widely used in thyroid surgery. This study aimed to investigate the influence of neck extension on electromyographic (EMG) endotracheal tube displacement and to determine the necessity of routinely checking the final electrode position after the patient had been fully positioned. A consecutive 220 patients undergoing thyroidectomy were enrolled. All patients were intubated with the EMG endotracheal tube under direct laryngoscopy. The electrode position and tube displacement were routinely checked and measured by laryngofiberoscopy before and after patient positioning. The patients were divided into two groups. In Group I (n = 110), the EMG tube was taped and fixed to the right mouth angle before full neck extension. In Group II (n = 110), the EMG tube was disconnected from the circuit tube and was not taped until full neck extension. In all patients, we ensured that the final electrode position was the optimal position with laryngofiberoscopic examination. The tube displacement after neck extension ranged from 16 mm upward to 4 mm downward in Group I and from 12 mm upward to 5 mm downward in Group II. The rate of tube displacement greater than 10 mm was 12.7{\%} in Group I and 3.6{\%} in Group II. Successful monitoring was achieved in all patients after the final optimal position of electrodes was ensured routinely. The electrode position can be severely displaced after the patient has been fully positioned. Verification of ideal position of electrodes before the beginning of the operation is a necessary step to guarantee functional intraoperative neuromonitoring.",
author = "Tsai, {Cheng Jing} and Tseng, {Kuang Yi} and Wang, {Fuy Uan} and Lu, {I. Cheng} and Wang, {Hsun Mo} and Wu, {Che Wei} and Chiang, {Hui Ching} and Chiang, {Feng Yu}",
year = "2011",
month = "3",
day = "1",
doi = "10.1016/j.kjms.2010.08.002",
language = "English",
volume = "27",
pages = "96--101",
journal = "Kaohsiung Journal of Medical Sciences",
issn = "1607-551X",
publisher = "Elsevier (Singapore) Pte Ltd",
number = "3",

}

Electromyographic endotracheal tube placement during thyroid surgery in neuromonitoring of recurrent laryngeal nerve. / Tsai, Cheng Jing; Tseng, Kuang Yi; Wang, Fuy Uan; Lu, I. Cheng; Wang, Hsun Mo; Wu, Che Wei; Chiang, Hui Ching; Chiang, Feng Yu.

In: Kaohsiung Journal of Medical Sciences, Vol. 27, No. 3, 01.03.2011, p. 96-101.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Electromyographic endotracheal tube placement during thyroid surgery in neuromonitoring of recurrent laryngeal nerve

AU - Tsai, Cheng Jing

AU - Tseng, Kuang Yi

AU - Wang, Fuy Uan

AU - Lu, I. Cheng

AU - Wang, Hsun Mo

AU - Wu, Che Wei

AU - Chiang, Hui Ching

AU - Chiang, Feng Yu

PY - 2011/3/1

Y1 - 2011/3/1

N2 - Intraoperative neuromonitoring (IONM) is widely used in thyroid surgery. This study aimed to investigate the influence of neck extension on electromyographic (EMG) endotracheal tube displacement and to determine the necessity of routinely checking the final electrode position after the patient had been fully positioned. A consecutive 220 patients undergoing thyroidectomy were enrolled. All patients were intubated with the EMG endotracheal tube under direct laryngoscopy. The electrode position and tube displacement were routinely checked and measured by laryngofiberoscopy before and after patient positioning. The patients were divided into two groups. In Group I (n = 110), the EMG tube was taped and fixed to the right mouth angle before full neck extension. In Group II (n = 110), the EMG tube was disconnected from the circuit tube and was not taped until full neck extension. In all patients, we ensured that the final electrode position was the optimal position with laryngofiberoscopic examination. The tube displacement after neck extension ranged from 16 mm upward to 4 mm downward in Group I and from 12 mm upward to 5 mm downward in Group II. The rate of tube displacement greater than 10 mm was 12.7% in Group I and 3.6% in Group II. Successful monitoring was achieved in all patients after the final optimal position of electrodes was ensured routinely. The electrode position can be severely displaced after the patient has been fully positioned. Verification of ideal position of electrodes before the beginning of the operation is a necessary step to guarantee functional intraoperative neuromonitoring.

AB - Intraoperative neuromonitoring (IONM) is widely used in thyroid surgery. This study aimed to investigate the influence of neck extension on electromyographic (EMG) endotracheal tube displacement and to determine the necessity of routinely checking the final electrode position after the patient had been fully positioned. A consecutive 220 patients undergoing thyroidectomy were enrolled. All patients were intubated with the EMG endotracheal tube under direct laryngoscopy. The electrode position and tube displacement were routinely checked and measured by laryngofiberoscopy before and after patient positioning. The patients were divided into two groups. In Group I (n = 110), the EMG tube was taped and fixed to the right mouth angle before full neck extension. In Group II (n = 110), the EMG tube was disconnected from the circuit tube and was not taped until full neck extension. In all patients, we ensured that the final electrode position was the optimal position with laryngofiberoscopic examination. The tube displacement after neck extension ranged from 16 mm upward to 4 mm downward in Group I and from 12 mm upward to 5 mm downward in Group II. The rate of tube displacement greater than 10 mm was 12.7% in Group I and 3.6% in Group II. Successful monitoring was achieved in all patients after the final optimal position of electrodes was ensured routinely. The electrode position can be severely displaced after the patient has been fully positioned. Verification of ideal position of electrodes before the beginning of the operation is a necessary step to guarantee functional intraoperative neuromonitoring.

UR - http://www.scopus.com/inward/record.url?scp=79952955056&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79952955056&partnerID=8YFLogxK

U2 - 10.1016/j.kjms.2010.08.002

DO - 10.1016/j.kjms.2010.08.002

M3 - Article

VL - 27

SP - 96

EP - 101

JO - Kaohsiung Journal of Medical Sciences

JF - Kaohsiung Journal of Medical Sciences

SN - 1607-551X

IS - 3

ER -