{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:19:26Z","timestamp":1777393166692,"version":"3.51.4"},"reference-count":16,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,8,27]],"date-time":"2019-08-27T00:00:00Z","timestamp":1566864000000},"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":[[2020,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To prospectively evaluate 1) use of endotracheal tube (ETT) surface electrodes for recurrent laryngeal nerve (RLN) monitoring in thyroid surgery in children, and 2) effects of thyroid surgery on the RLN in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients &lt;18\u2009years old undergoing thyroidectomy were included. Vocal cord mobility was assessed pre\u2010 and postoperatively. RLNs were monitored using adhesive or integrated electrodes. Recordings were made before and after dissection, and area under the curve and latency were compared using mixed models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010five children (44 nerves at risk), mean (standard deviation) age 13.1 (3.4) years (range 4.5\u201317.4\u2009years), underwent thyroidectomy. Twelve (46%) monitors were adhesive. One nerve had unobtainable responses. Nerve\u00e4na Power Index (NPI) (Neurovision Medical Products, Ventura, CA) decreased, and latency increased pre\u2010 versus postdissection at all amplitudes (<jats:italic>P<\/jats:italic> &lt;\u20090.0001), with change in slope of NPI affected by tumor size (<jats:italic>P<\/jats:italic> &lt;\u20090.05). Postdissection, the NPI was lower, and the latency was longer when stimulating low in the neck versus near the cricothyroid joint at all stimulating amplitudes (<jats:italic>P<\/jats:italic> &lt;\u20090.0001), with change in NPI related to tumor size (<jats:italic>P<\/jats:italic> &lt;\u20090.0001). Changes were not associated with decreased vocal cord mobility, aspiration, or voice change. One patient had a temporary unilateral paresis that resolved by 7\u2009weeks, and another had normal movement 3\u2009weeks postoperatively and developed a paresis 2 months postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ETT surface electrodes are reliable for RLN monitoring in thyroid surgery in children. Thyroid surgery is associated with a decrease in RLN stimulability that is related to tumor size. The site of RLN stimulation matters when evaluating the nerve.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:bold><jats:italic>Laryngoscope, 130:1583\u20131589, 2020<\/jats:italic><\/jats:bold><\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28250","type":"journal-article","created":{"date-parts":[[2019,8,27]],"date-time":"2019-08-27T16:01:47Z","timestamp":1566921707000},"page":"1583-1589","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Recurrent laryngeal nerve monitoring with surface electrodes in pediatric thyroid surgery"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8013-8530","authenticated-orcid":false,"given":"Evan Jon","family":"Propst","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Hospital for Sick Children, University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonah","family":"Gorodensky","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Hospital for Sick Children, University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan Daniel","family":"Wasserman","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Pediatrics Hospital for Sick Children, University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ethan Forde","family":"Glazman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Hospital for Sick Children, University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leona Ariel","family":"Tilis","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Hospital for Sick Children, University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaus Ernst","family":"Wolter","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Hospital for Sick Children, University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,8,27]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2002.35403"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-017-4279-x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2014.0460"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812439278"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.8831"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-924738"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2008.520"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813475568"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anorl.2013.11.009"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10792"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2002.128483"},{"key":"e_1_2_7_13_1","unstructured":"FerranteMA SpiegelbergT TsaoBE. 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