Electromyographic endotracheal tube placement during thyroid surgery in neuromonitoring of recurrent laryngeal nerve
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 b...
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| Format: | Article |
| Language: | English |
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Wiley
2011-03-01
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| Series: | Kaohsiung Journal of Medical Sciences |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1607551X10000343 |
| _version_ | 1818318157248462848 |
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| author | Cheng-Jing Tsai Kuang-Yi Tseng Fu-Yuan Wang I-Cheng Lu Hsun-Mo Wang Che-Wei Wu Hui-Ching Chiang Feng-Yu Chiang 蔡承靜 曾光毅 王富元 盧奕丞 王遜模 吳哲維 姜慧菁 江豐裕 |
| author_facet | Cheng-Jing Tsai Kuang-Yi Tseng Fu-Yuan Wang I-Cheng Lu Hsun-Mo Wang Che-Wei Wu Hui-Ching Chiang Feng-Yu Chiang 蔡承靜 曾光毅 王富元 盧奕丞 王遜模 吳哲維 姜慧菁 江豐裕 |
| author_sort | Cheng-Jing Tsai |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-13T09:48:45Z |
| format | Article |
| id | doaj.art-9728d19777d64aafbb770e6df3c5c279 |
| institution | Directory Open Access Journal |
| issn | 1607-551X |
| language | English |
| last_indexed | 2024-12-13T09:48:45Z |
| publishDate | 2011-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Kaohsiung Journal of Medical Sciences |
| spelling | doaj.art-9728d19777d64aafbb770e6df3c5c2792022-12-21T23:51:59ZengWileyKaohsiung Journal of Medical Sciences1607-551X2011-03-012739610110.1016/j.kjms.2010.08.002Electromyographic endotracheal tube placement during thyroid surgery in neuromonitoring of recurrent laryngeal nerveCheng-Jing Tsai0Kuang-Yi Tseng1Fu-Yuan Wang2I-Cheng Lu3Hsun-Mo Wang4Che-Wei Wu5Hui-Ching Chiang6Feng-Yu Chiang7蔡承靜8曾光毅9王富元10盧奕丞11王遜模12吳哲維13姜慧菁14江豐裕15Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Otolaryngology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, TaiwanGraduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Otolaryngology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Otolaryngology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, TaiwanGraduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Otolaryngology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanIntraoperative 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.http://www.sciencedirect.com/science/article/pii/S1607551X10000343EMG endotracheal tubeEndotracheal tube displacementIntraoperative neuromonitoringThyroid surgery |
| spellingShingle | Cheng-Jing Tsai Kuang-Yi Tseng Fu-Yuan Wang I-Cheng Lu Hsun-Mo Wang Che-Wei Wu Hui-Ching Chiang Feng-Yu Chiang 蔡承靜 曾光毅 王富元 盧奕丞 王遜模 吳哲維 姜慧菁 江豐裕 Electromyographic endotracheal tube placement during thyroid surgery in neuromonitoring of recurrent laryngeal nerve Kaohsiung Journal of Medical Sciences EMG endotracheal tube Endotracheal tube displacement Intraoperative neuromonitoring Thyroid surgery |
| title | Electromyographic endotracheal tube placement during thyroid surgery in neuromonitoring of recurrent laryngeal nerve |
| title_full | Electromyographic endotracheal tube placement during thyroid surgery in neuromonitoring of recurrent laryngeal nerve |
| title_fullStr | Electromyographic endotracheal tube placement during thyroid surgery in neuromonitoring of recurrent laryngeal nerve |
| title_full_unstemmed | Electromyographic endotracheal tube placement during thyroid surgery in neuromonitoring of recurrent laryngeal nerve |
| title_short | Electromyographic endotracheal tube placement during thyroid surgery in neuromonitoring of recurrent laryngeal nerve |
| title_sort | electromyographic endotracheal tube placement during thyroid surgery in neuromonitoring of recurrent laryngeal nerve |
| topic | EMG endotracheal tube Endotracheal tube displacement Intraoperative neuromonitoring Thyroid surgery |
| url | http://www.sciencedirect.com/science/article/pii/S1607551X10000343 |
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