{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T13:17:31Z","timestamp":1783775851766,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,8,18]],"date-time":"2018-08-18T00:00:00Z","timestamp":1534550400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Continuous vagal intraoperative neuromonitoring (IONM) currently requires placement of a vagal nerve electrode. Herein, we present data from 100 patients (134 nerves\u2010at\u2010risk) monitored continuously during neck endocrine surgeries using a noninvasive, new methodology that solely utilizes endotracheal tube electrodes to simultaneously stimulate laryngeal mucosa and record a laryngeal adductor reflex continuous IONM (LAR\u2010C\u2010IONM) response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The laryngeal adductor reflex (LAR) was elicited by electrical laryngeal mucosal stimulation on the side contralateral to the operative field using endotracheal tube electrodes. All patients completed preoperative and postoperative laryngeal and voice examinations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred patients (134 nerves\u2010at\u2010risk) were included. Significantly more nerves\u2010at\u2010risk with an LAR opening to closing amplitude decrement &gt;60% or with absolute closing amplitude &lt;100 \u03bcV had postoperative vocal fold paralysis (<jats:italic>P<\/jats:italic> &lt; .001). The LAR\u2010C\u2010IONM was highly sensitive to recurrent laryngeal nerve (RLN) stretch or compression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The LAR\u2010C\u2010IONM is a promising new way to perform continuous vagal monitoring that requires no equipment other than an electromyography (EMG) endotracheal tube and is undergoing further, large\u2010scale evaluation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.25377","type":"journal-article","created":{"date-parts":[[2018,8,18]],"date-time":"2018-08-18T15:54:52Z","timestamp":1534607692000},"page":"2498-2506","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":59,"title":["Noninvasive, tube\u2010based, continuous vagal nerve monitoring using the laryngeal adductor reflex: Feasibility study of 134 nerves at risk"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7129-7372","authenticated-orcid":false,"given":"Catherine F.","family":"Sinclair","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2010 Head and Neck Surgery Mount Sinai West Hospital  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria J.","family":"T\u00e9llez","sequence":"additional","affiliation":[{"name":"Department of Intraoperative Neurophysiology Mount Sinai West Hospital  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sedat","family":"Ulkatan","sequence":"additional","affiliation":[{"name":"Department of Intraoperative Neurophysiology Mount Sinai West Hospital  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,8,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2008.01875.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2005.08.009"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813487301"},{"key":"e_1_2_6_5_1","first-page":"369","article-title":"What benefits does neural monitoring bring to thyroid surgery? 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