ThyroidectomyNCT06801444
Comparison of Intr-operative Neuromonitoring Technique in Trans-oral Endoscopic Thyroidectomy Vestibular Approach
An observational study of Thyroidectomy, run by China Medical University Hospital at 1 site in Taiwan.
Trial summary
Transoral endoscopic thyroidectomy vestibular approach (TOETVA) has the advantage of scarless cosmesis but has limitations of recurrent laryngeal nerve (RLN) palsy. Intermittent intraoperative neuromonitoring (I-IONM) techniques have been utilized during TOETVA to identify and map RLN to prevent RLN injury. Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- Thyroidectomy
- How many people
- 304 participants
- Where
- 1 siteTaiwan
- Study dates
- 29 Mar 2023to 11 Dec 2025
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Study population: Patients undergoing transoral vestibular endoscopic total thyroidectomy.
Inclusion Criteria: Benign solitary or multiple thyroid nodules, follicular lesions (the largest diameter <6.0 cm), and early papillary thyroid carcinoma (<1 cm in diameter, without cervical lymphadenopathy)
Exclusion Criteria: History of thyroid surgery, neck radiotherapy, and recurrent laryngeal nerve paralysis; intraoperative conversion to conventional thyroidectomy.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Taiwan1 site, 1 recruiting
- Recruiting
China Medical University Hospital
Taichung, 404
Yih-Huei Uen, 886-4-37061668, d84306@yahoo.com.tw
About this study
Transoral endoscopic thyroidectomy vestibular approach (TOETVA) has the advantage of scarless cosmesis but has limitations of recurrent laryngeal nerve (RLN) palsy. Intermittent intraoperative neuromonitoring (I-IONM) techniques have been utilized during TOETVA to identify and map RLN to prevent RLN injury. However, the insult may still occur between two neural stimulations. Continuous intraoperative neuromonitoring (C-IONM) has been used in TOETVA to persistent stimulation of RLN. but only in our hospital. This rare use may be related to technical challenges. Recently, we successfully developed a novel technique of percutaneous C-IONM using an external fixator to secure the stimulation probe to steadily monitor the real-time functional status of RLN during the TOETVA. In this retrospective study, 304 patients undergone TOETVA were enrolled and divided according to the usage of IONM techniques into percutaneous or peroral intermittent and continuous groups. Patient's age, sex, BMI, thyroid disease, operation time, EMG signal and RLN palsy rate were compared to verified the feasibility, safety, and effectiveness of different IONM techniques. We hypothesized percutaneous C-IONM has the superiority in early detection of RLN injury and reducing of RLN palsy in TOETVA.
- Conditions
- Thyroidectomy
What is being measured
The primary outcome is the main question the study is designed to answer.
Electrode set up time refers to the time (min) from endoscopic or percutaneous insertion of electrode to functional set up of neural stimulation
Measured: through study completion, an average of one year
Operative time refers to the time (min) from incision wound making to complete wound closure
Measured: through study completion, an average of one year
Times of intraoperative displacement of stimulator electrode refers to total number of electrode displacement resulting in abnormal EMG signal
Measured: through study completion, an average of one year
Stimulation intensity refers to the level (mA) of stimulation current used
Measured: through study completion, an average of one year
Recurrent laryngeal nerve palsy refers to the presence of fixed or immobile vocal cord in laryngeal scopic examination
Measured: through study completion, an average of one year
EMG signals refers to the amplitude (μV) and latency (ms) of biphasic EMG wave recorded from vocal cord with neural stimulation
Measured: through study completion, an average of one year
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Jan 2025
- Study start29 Mar 2023
- Primary completion11 Dec 2025 (estimated)
- Study completion11 Dec 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (8)Papers the sponsor has linked to this study.
- Other trials for ThyroidectomyStudies of the same condition, open and under way.
- More trials run by China Medical University HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Retrospective
- Enrolment
- 304 participants (estimated)
Sponsor and investigators
- Lead sponsor
- China Medical University Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Yih-Huei Uen, China Medical University Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06801444
- Sponsor's protocol ID
- CMUH113-REC3-170
- Status last verified
- Jan 2025
- First submitted
- 7 Jan 2025
- Last updated
- 30 Jan 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes
Publications
Chen HK, Chen CL, Wen KS, Lin YF, Lin KY, Uen YH. Application of transoral continuous intraoperative neuromonitoring in natural orifice transluminal endoscopic surgery for thyroid disease: a preliminary study. Surg Endosc. 2018 Jan;32(1):517-525. doi: 10.1007/s00464-017-5656-0. Epub 2017 Jun 22.
PubMed 28643050Lamade W, Ulmer C, Seimer A, Molnar V, Meyding-Lamade U, Thon KP, Koch KP. A new system for continuous recurrent laryngeal nerve monitoring. Minim Invasive Ther Allied Technol. 2007;16(3):149-54. doi: 10.1080/13645700701383241.
PubMed 17573619Schneider R, Machens A, Sekulla C, Lorenz K, Elwerr M, Dralle H. Superiority of continuous over intermittent intraoperative nerve monitoring in preventing vocal cord palsy. Br J Surg. 2021 May 27;108(5):566-573. doi: 10.1002/bjs.11901.
PubMed 34043775Lombardi CP, De Waure C, Mariani M, Carnassale G, D'Amore A, Traini E, De Crea C, Raffaelli M, Damiani G. Efficacy of continuous neuromonitoring in thyroid surgery: preliminary report of a single-center experience. Gland Surg. 2019 Aug;8(4):336-342. doi: 10.21037/gs.2019.08.02.
PubMed 31538057Schneider R, Randolph G, Dionigi G, Barczynski M, Chiang FY, Triponez F, Vamvakidis K, Brauckhoff K, Musholt TJ, Almquist M, Innaro N, Jimenez-Garcia A, Kraimps JL, Miyauchi A, Wojtczak B, Donatini G, Lombardi D, Muller U, Pezzullo L, Ratia T, Van Slycke S, Nguyen Thanh P, Lorenz K, Sekulla C, Machens A, Dralle H. Prospective study of vocal fold function after loss of the neuromonitoring signal in thyroid surgery: The International Neural Monitoring Study Group's POLT study. Laryngoscope. 2016 May;126(5):1260-6. doi: 10.1002/lary.25807. Epub 2015 Dec 15.
PubMed 26667156Chiang FY, Lu IC, Chang PY, Sun H, Wang P, Lu XB, Chen HC, Chen HY, Kim HY, Dionigi G, Wu CW. Stimulating dissecting instruments during neuromonitoring of RLN in thyroid surgery. Laryngoscope. 2015 Dec;125(12):2832-7. doi: 10.1002/lary.25251. Epub 2015 Mar 26.
PubMed 25809677Liu XL, Wu CW, Zhao YS, Wang T, Chen P, Xin JW, Li SJ, Zhang DQ, Zhang G, Fu YT, Zhao LN, Zhou L, Dionigi G, Chiang FY, Sun H. Exclusive real-time monitoring during recurrent laryngeal nerve dissection in conventional monitored thyroidectomy. Kaohsiung J Med Sci. 2016 Mar;32(3):135-41. doi: 10.1016/j.kjms.2016.02.004. Epub 2016 Mar 30.
PubMed 27106003Tae K. Complications of Transoral Thyroidectomy: Overview and Update. Clin Exp Otorhinolaryngol. 2021 May;14(2):169-178. doi: 10.21053/ceo.2020.02110. Epub 2020 Nov 19.
PubMed 33211953
Study at a glance
From the registry record, last updated by the sponsor on 30 Jan 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of Intr-operative Neuromonitoring Technique in Trans-oral Endoscopic Thyroidectomy Vestibular Approach
- ClinicalTrials.gov ID
- NCT06801444
- Acronym / sponsor ID
- CMUH113-REC3-170
- Conditions
- Thyroidectomy
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 304 participants (estimated)
- Lead sponsor
- China Medical University HospitalUniversity, hospital or other
- Study start
- 29 Mar 2023 (actual)
- Primary completion
- 11 Dec 2025 (estimated)
- Study completion
- 11 Dec 2025 (estimated)
- First posted
- 30 Jan 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Transoral endoscopic thyroidectomy vestibular approach (TOETVA) has the advantage of scarless cosmesis but has limitations of recurrent laryngeal nerve (RLN) palsy. Intermittent intraoperative neuromonitoring (I-IONM) techniques have been utilized during TOETVA to identify and map RLN to prevent RLN injury. However, the insult may still occur between two neural stimulations. Continuous intraoperative neuromonitoring (C-IONM) has been used in TOETVA to persistent stimulation of RLN. but only in our hospital. This rare use may be related to technical challenges. Recently, we successfully developed a novel technique of percutaneous C-IONM using an external fixator to secure the stimulation probe to steadily monitor the real-time functional status of RLN during the TOETVA. In this retrospective study, 304 patients undergone TOETVA were enrolled and divided according to the usage of IONM techniques into percutaneous or peroral intermittent and continuous groups. Patient's age, sex, BMI, thyroid disease, operation time, EMG signal and RLN palsy rate were compared to verified the feasibility, safety, and effectiveness of different IONM techniques. We hypothesized percutaneous C-IONM has the superiority in early detection of RLN injury and reducing of RLN palsy in TOETVA.
Study design
- Observational model
- Cohort
- Time perspective
- Retrospective
Who may qualify
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
- Study population
- Patients undergoing transoral vestibular endoscopic total thyroidectomy.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Electrode set up time refers to the time (min) from endoscopic or percutaneous insertion of electrode to functional set up of neural stimulation
Time frame: through study completion, an average of one year
Operative time refers to the time (min) from incision wound making to complete wound closure
Time frame: through study completion, an average of one year
Times of intraoperative displacement of stimulator electrode refers to total number of electrode displacement resulting in abnormal EMG signal
Time frame: through study completion, an average of one year
Stimulation intensity refers to the level (mA) of stimulation current used
Time frame: through study completion, an average of one year
Recurrent laryngeal nerve palsy refers to the presence of fixed or immobile vocal cord in laryngeal scopic examination
Time frame: through study completion, an average of one year
EMG signals refers to the amplitude (μV) and latency (ms) of biphasic EMG wave recorded from vocal cord with neural stimulation
Time frame: through study completion, an average of one year
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 30 Jan 2025.
- Results publication: PubMed 28643050Chen HK, Chen CL, Wen KS, Lin YF, Lin KY, Uen YH. Application of transoral continuous intraoperative neuromonitoring in natural orifice transluminal endoscopic surgery for thyroid disease: a preliminary study. Surg Endosc. 2018 Jan;32(1):517-525. doi: 10.1007/s00464-017-5656-0. Epub 2017 Jun 22.
- Results publication: PubMed 17573619Lamade W, Ulmer C, Seimer A, Molnar V, Meyding-Lamade U, Thon KP, Koch KP. A new system for continuous recurrent laryngeal nerve monitoring. Minim Invasive Ther Allied Technol. 2007;16(3):149-54. doi: 10.1080/13645700701383241.
- Results publication: PubMed 34043775Schneider R, Machens A, Sekulla C, Lorenz K, Elwerr M, Dralle H. Superiority of continuous over intermittent intraoperative nerve monitoring in preventing vocal cord palsy. Br J Surg. 2021 May 27;108(5):566-573. doi: 10.1002/bjs.11901.
- Results publication: PubMed 31538057Lombardi CP, De Waure C, Mariani M, Carnassale G, D'Amore A, Traini E, De Crea C, Raffaelli M, Damiani G. Efficacy of continuous neuromonitoring in thyroid surgery: preliminary report of a single-center experience. Gland Surg. 2019 Aug;8(4):336-342. doi: 10.21037/gs.2019.08.02.
- Results publication: PubMed 26667156Schneider R, Randolph G, Dionigi G, Barczynski M, Chiang FY, Triponez F, Vamvakidis K, Brauckhoff K, Musholt TJ, Almquist M, Innaro N, Jimenez-Garcia A, Kraimps JL, Miyauchi A, Wojtczak B, Donatini G, Lombardi D, Muller U, Pezzullo L, Ratia T, Van Slycke S, Nguyen Thanh P, Lorenz K, Sekulla C, Machens A, Dralle H. Prospective study of vocal fold function after loss of the neuromonitoring signal in thyroid surgery: The International Neural Monitoring Study Group's POLT study. Laryngoscope. 2016 May;126(5):1260-6. doi: 10.1002/lary.25807. Epub 2015 Dec 15.
- Results publication: PubMed 25809677Chiang FY, Lu IC, Chang PY, Sun H, Wang P, Lu XB, Chen HC, Chen HY, Kim HY, Dionigi G, Wu CW. Stimulating dissecting instruments during neuromonitoring of RLN in thyroid surgery. Laryngoscope. 2015 Dec;125(12):2832-7. doi: 10.1002/lary.25251. Epub 2015 Mar 26.
- Results publication: PubMed 27106003Liu XL, Wu CW, Zhao YS, Wang T, Chen P, Xin JW, Li SJ, Zhang DQ, Zhang G, Fu YT, Zhao LN, Zhou L, Dionigi G, Chiang FY, Sun H. Exclusive real-time monitoring during recurrent laryngeal nerve dissection in conventional monitored thyroidectomy. Kaohsiung J Med Sci. 2016 Mar;32(3):135-41. doi: 10.1016/j.kjms.2016.02.004. Epub 2016 Mar 30.
- Results publication: PubMed 33211953Tae K. Complications of Transoral Thyroidectomy: Overview and Update. Clin Exp Otorhinolaryngol. 2021 May;14(2):169-178. doi: 10.21053/ceo.2020.02110. Epub 2020 Nov 19.
- Individual participant dataSharing planned: Yes
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Thyroidectomy, run by China Medical University Hospital at 1 site in Taiwan.
The full registered description is in the About this study section and the official record.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 30 Jan 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Taiwan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Yih-Huei Uen, MD (886-4-37061668, d84306@yahoo.com.tw), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Electrode set up time refers to the time (min) from endoscopic or percutaneous insertion of electrode to functional set up of neural stimulation (time frame: through study completion, an average of one year). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06801444, which also lists 8 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Jan 2025.