Application of Skin Electrodes for Intraoperative Neuromonitoring of Recurrent Laryngeal Nerve

Efficiency of intraoperative neuromonitoring (IONM) for recurrent laryngeal nerve (RLN) during thyroid or parathyroid surgery has been well established. Electromyogram (EMG) tube has been utilized as a standard method of IONM for RLN. However, limitations of EMG tube including false positive signals due to malposition of the tube and relatively high cost have been issued. Recently, there have been several alternative methods using variable types of skin electrodes to overcome the limitations of conventional EMG tube. These recent methods using skin electrodes will be reviewed in this article.