What is the correlation of physiologically important electromyographic (EMG) waveforms with demonstrable muscle activation used for the reliable interpretation of evoked waveforms during intraoperative neural monitoring (IONM) of the vagus nerve, recurrent laryngeal nerve (RLN), and external branch of the superior laryngeal nerve (EBSLN) in thyroid surgery?
Target musculature is the primary innervated muscle that produces the highest EMG amplitude and is the sole muscle grossly contracting with nerve stimulation.
Explore this issue:March 2017
Background: IONM provides additional functional information during thyroid surgery. Confusion in interpretation of IONM data can ensue when intraoperative EMG waveforms are recorded in isolation from true demonstrable muscular response. Direct stimulation of local muscle fibers with resultant regional contraction could be confused with neural stimulation of a branch of the RLN or EBSLN if EMG morphology is not interpreted correctly.
Study design: Retrospective chart review of 50 surgical sides from 37 thyroid surgery patients with laryngeal nerve IONM from January to December 2015.