Effect of Electromyography Findings of Traction-Related Signal Loss on Prognosis During Neuromonitored Thyroidectomy.

BACKGROUND

Intraoperative neuromonitoring (IONM) is a reliable tool to detect electromyographic loss of signal (LOS). Here, we investigated the effect of electromyography features of traction-related LOS on prognosis.

METHODS

Thyroidectomy patients with a traction-related LOS were included. The cases were divided into four groups as follows: Type 1 LOS with no amplitude (0 μV) (Group 1), Type 1 LOS with low-amplitude (1-99 μV) (Group 2), Type 2 LOS with no amplitude (Group 3), and Type 2 LOS with low-amplitude (Group 4).

RESULTS

A total of 788 patients (1429 nerves) were analyzed. Traction-related LOS was found in 74 patients (9.4%) and 77 nerves (5.4%). Intraoperative recovery was observed in 21 (48.8%) nerves in Group 4, and significantly higher (p = 0.011). Vocal cord paralysis was less in Group 4 (p = 0.001).

CONCLUSIONS

In traction-related injury, electromyography features may contribute to the decision-making process. Type 2 LOS with low-amplitude is associated with a high likelihood of intraoperative recovery, potentially reducing the need for staged thyroidectomy.