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Background and Objectives Variable types of electrodes for intraoperative neuromonitoring(IONM) during thyroid surgery have been introduced to make up for the shortcomings ofconventional endotracheal electromyogram tube. In this study, we sought to evaluate the efficacyof transcutaneous adhesive skin electrodes for IONM of recurrent laryngeal nerve (RLN)during thyroidectomy. Subjects and Method A total 97 nerves at risk of 80 patients were enrolled in this study. Two disposable adhesive skin electrodes were attached at both upper margins of thyroid cartilage. Using NIM 3.0 system (Medtronic), we recorded the amplitude and latency of signals ofvagus nerve and RLN following the standard procedure of IONM. Clinicopathologic factors aswell as the preoperative and postoperative vocal cord functions of the patients were analyzed. Results IONM was successful in all nerves at risk without any false loss of signals. Therewere no complications nor any significant time delay due to adhesive skin electrodes. The meanamplitudes from the vagus nerve (V1) and RLN (R1) were 230.64 μV and 293.48 μV, respectively. Two nerves at risk showed loss of signal and the two patients showed postoperative temporaryvocal cord paralysis. The amplitude of signals from the vagus nerve (V1, V2) was significantlyhigher in the lower body mass index (BMI) group compared to that of the higher BMIgroup. Conclusion IONM using transcutaneous skin electrodes may be considered as an alternativetechnique for IONM during thyroid surgery.
