Safety parameters of ferromagnetic device during thyroid surgery: Porcine model using continuous neuromonitoring

Tzu Yen Huang, Yi Chu Lin, Hsin Yi Tseng, Gianlorenzo Dionigi, Hoon Yub Kim, Young Jun Chai, I. Cheng Lu, Pi Ying Chang, Feng Yu Chiang, Che Wei Wu

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)


Background: The ferromagnetic (FM) device is a new surgical energy modality. This study investigated dynamic recurrent laryngeal nerve (RLN) electromyographic (EMG) data to define safety parameters for using FM devices in thyroidectomy. Methods: Real-time EMG tracings obtained under continuous neuromonitoring were recorded from 24 RLNs (12 piglets). In the activation study, FM devices were activated at varying distances from the RLN. In the cooling study, FM devices were cooled for varying time intervals, or muscle touch maneuver was performed, before contact with the RLN. Results: During the FMwand/FMsealer activation, no adverse EMG events occurred at distances of 2 mm or longer. The cooling study revealed no adverse EMG events after 1-second (FMwand) or 3-second (FMsealer) intervals or after muscle touch maneuver. Conclusions: An FM device should be activated at a distance of 2 mm from the RLN and should be adequately cooled before further contact with the RLN. Surgeons can avoid RLN injury by observing standard procedures for using FM devices.

Original languageEnglish
Pages (from-to)2931-2940
Number of pages10
JournalHead and Neck
Issue number10
Publication statusPublished - 2020 Oct 1
Externally publishedYes


  • continuous intraoperative neuromonitoring
  • ferromagnetic device
  • nerve thermal injury
  • recurrent laryngeal nerve
  • thyroid surgery

ASJC Scopus subject areas

  • Otorhinolaryngology


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