Intraoperative nerve monitoring(IONM) is becoming routine in parathyroid surgery. This study presents a cheap alternative IONM technique, the percutaneous thyroid cartilage needle (pTCN) electrode, to the laryngeal tube electrode (LTE) in patients undergoing mini-incision parathyroidectomy.

Data were retrospectively analyzed from patients who underwent mini-incision parathyroidectomy at the Ege University Endocrine Surgery Clinic between April 2023 and November 2023. The patient's age, gender, comorbidities, lesion size, localization of the parathyroid adenoma, preoperative calcium and parathormone levels, intraoperative parathormone levels, and nerve monitoring values were examined. The pTCNs were percutaneously placed into the thyroid cartilage under ultrasonographic guidance just before the incision.

Twelve patients (One male and 11 female) were included in the study. The average amplitude values are as follows: V1: 1850 µV (200-4230), R1: 1730 µV (220-3500), V2: 1690 µV (280-3370), R2: 2140 µV (290-3750). There was no loss of signal in any of the patients. Perioperative parathormone levels were measured in all patients (mean: 23,4 ng/L), and the parathormone levels of all patients decreased by at least 50% compared to the preoperative values (mean: 113,9 ng/L)

Using the pTCN method in mini-incision parathyroidectomy ensures the preservation of the nerve inexpensively (approximately 20 times cheaper than LTE) while allowing the operation's safe completion through a small surgical incision.