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Endotracheal Tube Versus Transcartilage Needle Electrodes for Nerve Monitoring in Thyroid Surgery
Sponsor: Marmara University
Summary
Intraoperative neuromonitoring of the recurrent laryngeal nerve during thyroidectomy is most commonly performed with surface electrodes embedded in the endotracheal tube (ETT). ETT electrodes are prone to malposition, rotation and secretions, which can produce low signal amplitudes and false signal loss. Transcartilage needle electrodes (TCN), placed into the thyroid cartilage, have been reported to yield higher and more stable amplitudes. This single-center prospective study records ETT and TCN signals simultaneously in the same patient during thyroidectomy, so that each patient serves as their own control. The primary aim is to compare how often each electrode type shows a false amplitude decrease of more than 50% in nerves without true injury. Voice and swallowing outcomes are assessed before surgery and at 2 weeks and 3 months after surgery using the Turkish versions of the Voice Handicap Index-10 and the Eating Assessment Tool-10.
Official title: Comparison of Endotracheal Tube Surface Electrodes and Transcartilage Needle Electrodes for Intraoperative Neuromonitoring During Thyroidectomy: A Prospective Within-Patient Comparison
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
100
Start Date
2026-11-01
Completion Date
2027-09-30
Last Updated
2026-10-30
Healthy Volunteers
No
Interventions
Transcartilage needle electrode recording
Paired needle electrodes are inserted into the anterior thyroid cartilage in the subperichondrial plane through the existing neck incision at the start of the operation, and removed at the end. Electromyographic responses to vagal and recurrent laryngeal nerve stimulation are recorded at vagal stimulation before dissection (V1), recurrent laryngeal nerve stimulation after identification (R1), recurrent laryngeal nerve stimulation after completion of lobar dissection (R2) and vagal stimulation at the end of the procedure (V2).
Endotracheal tube surface electrode recording
A standard neuromonitoring endotracheal tube with surface electrodes is positioned at intubation. Electromyographic responses to vagal and recurrent laryngeal nerve stimulation are recorded at the same four stimulation steps, simultaneously with the needle electrode channel.
Locations (1)
Marmara University School of Medicine Hospital, Department of General Surgery
Istanbul, Turkey (Türkiye)