{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T11:26:51Z","timestamp":1777116411286,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T00:00:00Z","timestamp":1681344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study evaluated the feasibility, stability, safety, and economy of cricothyroid membrane (CM)\u2010inserted needle electrodes for recurrent laryngeal nerve monitoring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Parallel and controlled study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Clinical research center for thyroid diseases of Shaanxi province.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 64 patients in the needle electrodes group (104 recurrent laryngeal nerves [RLNs]) and 44 patients in the endotracheal tube (ETT)\u2010based electrodes group (80 RLNs) underwent monitored thyroidectomy. The evoked electromyography (EMG) signals detected by the 2 electrodes were recorded and analyzed. The changes in EMG during Berry's ligament traction and tracheal displacement were compared. All patients underwent preoperative and postoperative laryngoscopy within 1 week.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both electrodes successfully recorded typical evoked laryngeal EMG waveforms from RLNs. The needle electrodes recorded relatively higher amplitudes and similar latencies compared to ETT\u2010based electrodes. The evoked EMG signals attributed to needle electrodes could accurately predict the function of RLNs with 100% sensitivity and specificity. The reduction in the recorded amplitudes attributed to needle electrodes was higher than that observed with ETT\u2010based electrodes during Berry's ligament traction or trachea displacement, whereas a similar increase in the latencies was recorded in the 2 groups. Particularly, Berry's ligament traction was more likely to lead to EMG amplitude reduction and latency prolongation. The needle electrodes group recorded 2 cases of minor bleeding on the CM. The needle electrodes were more cost\u2010effective than ETT\u2010based electrodes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The CM\u2010inserted needle electrodes are feasible, stable, safe, and economical for RLN monitoring, and they provide an alternative novel intraoperative neural monitoring format for thyroid surgeons.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.338","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T04:46:28Z","timestamp":1681361188000},"page":"589-597","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Feasibility Study of Intraoperative RLN Monitoring Using Cricothyroid Membrane\u2010Inserted Needle Electrodes During Thyroid Surgery"],"prefix":"10.1002","volume":"169","author":[{"given":"Chongwen","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery The First Affiliated Hospital of Xi'an Jiaotong University Xi'an P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoxia","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Air Force 986 Hospital of Chinese People's Liberation Army The Fourth Military Medical University Xi'an P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junsong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery The First Affiliated Hospital of Xi'an Jiaotong University Xi'an P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinfeng","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery The First Affiliated Hospital of Xi'an Jiaotong University Xi'an P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaoqiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery The First Affiliated Hospital of Xi'an Jiaotong University Xi'an P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiwei","family":"Zheng","sequence":"additional","affiliation":[{"name":"The Third Ward of General Surgery Department Rizhao People's Hospital Rizhao P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qian","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery The First Affiliated Hospital of Xi'an Jiaotong University Xi'an P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery The First Affiliated Hospital of Xi'an Jiaotong University Xi'an P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanxia","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery The First Affiliated Hospital of Xi'an Jiaotong University Xi'an P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruimin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery The First Affiliated Hospital of Xi'an Jiaotong University Xi'an P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Honghui","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery The First Affiliated Hospital of Xi'an Jiaotong University Xi'an P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaobao","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery The First Affiliated Hospital of Xi'an Jiaotong University Xi'an P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,4,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-018-1739-5"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481808401232"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25133"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.8831"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kjms.2017.06.014"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10994"},{"issue":"1","key":"e_1_2_8_8_1","first-page":"26","article-title":"Expert consensus on enhanced recovery after surgery (ERAS) in thyroid surgery, 2018 edition","volume":"28","author":"Gao M","year":"2019","journal-title":"Chin\u00a0Oncol"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2017.0680"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24145"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-019-05178-6"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2017.0679"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-010-0691-5"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21119"},{"issue":"1","key":"e_1_2_8_15_1","first-page":"19","article-title":"Loss of signal in recurrent nerve neuromonitoring: causes and management","volume":"4","author":"Wu CW","year":"2015","journal-title":"Gland Surg"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10792"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anorl.2020.04.005"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26810"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1607-551X(10)70097-8"},{"issue":"8","key":"e_1_2_8_20_1","first-page":"1974","article-title":"Influences of cisatracurium besylate and vecuronium bromide on muscle relaxant effects and electromyography of tracheal intubation under general anesthesia","volume":"21","author":"Yu DJ","year":"2017","journal-title":"Eur Rev Med Pharmacol Sci"},{"issue":"4","key":"e_1_2_8_21_1","first-page":"397","article-title":"Influence of nondepolarizing muscle relaxants on intraoperative neuromonitoring during thyroid surgery","volume":"39","author":"Chu KS","year":"2010","journal-title":"J Otolaryngol\u00a0Head Neck Surg"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28835"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.338","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T11:53:26Z","timestamp":1760961206000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.338"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,13]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1002\/ohn.338"],"URL":"https:\/\/doi.org\/10.1002\/ohn.338","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,13]]},"assertion":[{"value":"2022-08-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}