New placement of recording electrodes on the thyroid cartilage in intra-operative neuromonitoring during thyroid surgery.

Objective During thyroid surgery, extreme caution is needed not to harm the recurrent laryngeal nerve and to avoid vocal cord palsy. Intra-operative neuromonitoring became increasingly popular as an adjunct to the gold standard of visual identification of the recurrent laryngeal nerve (RLN). Electromyographic (EMG) responses are normally recorded by electrodes attached to the endotracheal tube. Alteration in position can lead to false loss of signal. We developed thyroid cartilage electrodes that can be fixed directly onto the thyroid cartilage.