Abstract
One of the major complications of thyroid surgery is damage to the recurrent laryngeal nerve (RLN). This injury can be avoided by intraoperative nerve identification. A technique is described for electromyographic monitoring of the RLN during thyroidectomy. The RLN was electrically stimulated with a hand-held bipolar stimulator, delivering a voltage of 1 to 7 V. Hooked-wire electrodes were placed in the thyroarytenoid muscles through the cricothyroid membrane. Laryngeal evoked responses were readily recognized by a EMG waveform. No responses were evoked by stimulation of tissue 1 or 2 mm adjacent to the RLN. This procedure can be used to confirm the presence of the RLN during the course of the operation.
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