{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T14:11:45Z","timestamp":1783433505002,"version":"3.54.6"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,4,25]],"date-time":"2019-04-25T00:00:00Z","timestamp":1556150400000},"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":["The Laryngoscope"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The Checkpoint nerve stimulator (Checkpoint Surgical, Cleveland, OH) is a U.S. Food and Drug Administration\u2010approved device for neural localization and monitoring during surgery. Its safety, efficacy, and reliability for neural monitoring during thyroid and parathyroid surgery have not been compared to more standard formats of neural monitoring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Vagal, recurrent, and superior laryngeal nerve monitoring were performed using both the Checkpoint stimulator and Medtronic NIM 3.0 laryngeal electromyography endotracheal tube (Medtronic, Jacksonville, FL) during thyroid and parathyroid surgery. A total of 21 operated sides in 15 patients were included for analysis. Latency and amplitude data for the Checkpoint stimulator were recorded using the NIM monitor and compared to normative endotracheal tube surface electrode data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean amplitude using the Checkpoint stimulator was 574.6 microvolts (\u03bcV), 1060.6 \u03bcV, and 182.8 \u03bcV for the vagus, recurrent laryngeal, and superior laryngeal nerves, respectively. Mean amplitude using standard laryngeal electromyography was 709 \u03bcV, 1077.0 \u03bcV, and 183.7 \u03bcV for the same nerves. Mean latency was significantly shorter with stimulation of the recurrent laryngeal nerve compared to the vagus nerve with both stimulators (<jats:italic>P<\/jats:italic> &lt; 0.001). No neural injuries occurred during the study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The Checkpoint stimulator is a safe and reliable alternative to traditional laryngeal electromyography providing equivalent induced electromyography of the vocalis for neural monitoring during thyroid and parathyroid surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 130:561\u2013565, 2020<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28027","type":"journal-article","created":{"date-parts":[[2019,4,25]],"date-time":"2019-04-25T16:04:30Z","timestamp":1556208270000},"page":"561-565","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Safety and reliability of a handheld stimulator for neural monitoring during thyroid surgery"],"prefix":"10.1002","volume":"130","author":[{"given":"Bradley R.","family":"Lawson","sequence":"first","affiliation":[{"name":"Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary Harvard Medical School Boston  Massachusetts U.S.A."},{"name":"Licking Memorial Hospital  Newark U.S.A."},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery The Ohio State University College of Medicine  Columbus Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dipti","family":"Kamani","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary Harvard Medical School Boston  Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Shama","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary Harvard Medical School Boston  Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Kyriazidis","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary Harvard Medical School Boston  Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory W.","family":"Randolph","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary Harvard Medical School Boston  Massachusetts U.S.A."},{"name":"Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital Harvard Medical School Boston  Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,4,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-27727-1_14"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e3180de4d49"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-193810000-00006"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-008-0366-7"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198603000-00011"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.135.2.204"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2004.09.008"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24781"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26166"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21119"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24301"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-004-7348-x"},{"key":"e_1_2_7_14_1","unstructured":"BurchhardtD VongA HeilbronnC LinHS. Novel intraoperative technique for predicting post operative recurrent laryngeal nerve function in thyroid surgery. Available at:http:\/\/www.checkpointsurgical.com\/clinical\/novel\u2010intraoperative\u2010technique\u2010for\u2010predicting\u2010post\u2010operative\u2010recurrent\u2010laryngeal\u2010nerve\u2010function\u2010in\u2010thyroid\u2010surgery\u20102\/. 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