{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T20:08:16Z","timestamp":1782936496175,"version":"3.54.5"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T00:00:00Z","timestamp":1664236800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    In thyroid surgery, intra\u2010operative neuromonitoring signals of the recurrent laryngeal nerve can be detected by surface electrodes on a tracheal tube positioned at the vocal fold level. The incidence of difficult tracheal intubation in patients undergoing thyroidectomy for nodular goitre ranges from 5.3% to 20.5%. The aim of this study was to compare videolaryngoscopy with conventional direct laryngoscopy as methods for proper placement of the surface electrode to prevent insufficient intra\u2010operative nerve signal quality. In this prospective randomised trial, adult patients requiring tracheal intubation during thyroid surgery were randomly allocated to two groups of C\u2010MAC\n                    <jats:sup>\u00ae<\/jats:sup>\n                    (Macintosh style blade) videolaryngoscope or direct laryngoscopy using the Macintosh laryngoscope. Primary outcome was the incidence of insufficient signal electromyogram amplitude level (&lt;\u2009500\u2009\u03bcV) after successful tracheal intubation. A total of 260 (130 per group) participants were analysed. An insufficient signal was more frequent with direct laryngoscopy (35\/130, 27%), compared with C\u2010MAC (12\/130, 9%, p\u2009&lt;\u20090.001). First\u2010pass tracheal intubation success rate was lower with direct laryngoscopy (86\/130 (66%)) compared with the C\u2010MAC (125\/130 (96%)) (p\u2009&lt;\u20090.0001). Cormack and Lehane grade \u2265\u20093 was observed more frequently with direct laryngoscopy (16\/130 (12%)), compared with the C\u2010MAC (0\/130, (0%)) (p\u2009&lt;\u20090.0001). The results suggest that videolaryngoscopy has an impact on the quality of the initial intra\u2010operative neuromonitoring signal in patients undergoing thyroid surgery, and this technique can provide optimised surface electrode positioning.\n                  <\/jats:p>","DOI":"10.1111\/anae.15865","type":"journal-article","created":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T13:54:11Z","timestamp":1664286851000},"page":"55-63","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Impact of direct laryngoscopy vs. videolaryngoscopy on signal quality of recurrent laryngeal nerve monitoring in thyroid surgery: a randomised parallel group trial"],"prefix":"10.1111","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7350-7908","authenticated-orcid":false,"given":"M.","family":"Kriege","sequence":"first","affiliation":[{"name":"Department of Anesthesiology University Medical Centre of the Johannes Gutenberg University Mainz  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. A.","family":"Hilt","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University Medical Centre of the Johannes Gutenberg University Mainz  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Dette","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University Medical Centre of the Johannes Gutenberg University Mainz  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Wittenmeier","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University Medical Centre of the Johannes Gutenberg University Mainz  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Meuser","sequence":"additional","affiliation":[{"name":"Institute of Medical Biostatistics, Epidemiology and Informatics University Medical Centre of the Johannes Gutenberg University Mainz  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. I.","family":"Staubitz","sequence":"additional","affiliation":[{"name":"Section\u2009of Endocrine Surgery, Department of General, Visceral and Transplantation Surgery University Medical Centre of the Johannes Gutenberg University Mainz  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. J.","family":"Musholt","sequence":"additional","affiliation":[{"name":"Section\u2009of Endocrine Surgery, Department of General, Visceral and Transplantation Surgery University Medical Centre of the Johannes Gutenberg University Mainz  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1515\/iss-2017-0023"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/60.7.920"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489414524171"},{"key":"e_1_2_6_5_1","first-page":"9","article-title":"Predictors of difficult airway management in thyroid surgery: a five\u2010year observational single\u2010center prospective study","volume":"55","author":"Kalezi\u0107 N","year":"2016","journal-title":"Acta Clinical Croatia"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.2298\/VSP0905377K"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aet151"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2011.06650.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15668"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27360"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-013-1057-6"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-008-9549-1"},{"key":"e_1_2_6_13_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 Surgery"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21119"},{"key":"e_1_2_6_15_1","first-page":"79","article-title":"Continuous intraoperative neuromonitoring in thyroid surgery","volume":"27","author":"Angeletti F","year":"2015","journal-title":"Surgical Technology International"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40136-021-00353-7"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13714"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2011.06872.x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1097\/00003643-200000002-00114","article-title":"Airway Difficulty Score (ADS): a new score to predict difficulty in airway management","volume":"17","author":"Janssens M","year":"2000","journal-title":"European Journal of Anaesthesiology"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03021895"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2011.02541.x"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00101-015-0109-4"},{"key":"e_1_2_6_23_1","first-page":"1","article-title":"Canadian Airway Focus Group updated consensus\u2010based recommendations for management of the difficult airway: part 2. 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