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Normative electromyography data and influencing factors in intraoperative neuromonitoring using adhesive skin electrodes during thyroid surgery. | LitMetric

AI Article Synopsis

  • Skin electrodes can effectively record EMG waveforms during intraoperative neuromonitoring, though they generally produce lower evoked amplitudes compared to other methods.
  • In a study involving 167 patients undergoing thyroidectomy, EMG data were gathered from the recurrent laryngeal nerve and vagus nerve using skin electrodes, focusing on average amplitude and latency.
  • Results showed that evoked amplitudes were significantly lower in patients with obesity, male sex, and those undergoing total thyroidectomy, with amplitude decreasing as body mass index and age increased.

Article Abstract

Background: Skin electrodes have been reported to be a useful alternative recording method for intraoperative neuromonitoring (IONM) and show typical electromyography (EMG) waveforms while overcoming the shortcomings of the EMG endotracheal tube. However, the skin electrodes showed relatively lower evoked amplitudes than other recording methods. In this study, we analyzed normative EMG data using skin electrodes and factors that affect the evoked amplitude of thyroid IONM.

Methods: In total, 167 patients [242 nerves at risk (NAR)] who underwent thyroidectomy under IONM with adhesive skin electrodes were analyzed. A pair of skin electrodes was attached to the lateral border of the lamina of the thyroid cartilage. Evoked EMG data, including mean amplitude and latency, obtained after stimulation of the recurrent laryngeal nerve (RLN) and vagus nerve (VN), were collected and analyzed.

Results: The mean amplitudes of RLN and VN recorded via skin electrodes were 255.48±96.53 and 236.15±69.72 μV, respectively. The mean latency of the right and left RLN was 3.22±0.03 and 3.49±0.08 mS, respectively. The mean latency of the right and left VN was 5.37±0.80 and 7.57±0.10 mS, respectively. The mean amplitude was significantly lower in the obesity, male, and total thyroidectomy (TT) groups. As body mass index (BMI) and age increased, the amplitude of EMG tended to decrease significantly.

Conclusions: The evoked amplitude recorded with the skin electrodes was relatively low. A larger surgical extent, obesity, male sex, and age >55 years showed significantly lower evoked amplitudes.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11002475PMC
http://dx.doi.org/10.21037/gs-23-428DOI Listing

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