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Challenges in electromyographic endotracheal tube (EMG ETT) placement via awake fibreoptic intubation during emergency thyroidectomy
  1. Fathir Fath Mohammad Iskandar1,
  2. Nik Amin Sahid Nik Lah2,
  3. Abdul Jabbar Ismail3 and
  4. Tat Boon Yeap4
  1. 1Department of Surgery, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia
  2. 2Surgical Based Discplines Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
  3. 3Department of Anaesthesiology and Intensive Care Unit, Hospital Queen Elizabeth 2, Kota Kinabalu, Sabah, Malaysia
  4. 4Medicine Based Disciplines Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
  1. Correspondence to Dr Tat Boon Yeap; boontat{at}


Recurrent laryngeal nerve (RLN) injury is one of the main complications of total thyroidectomy. If the injury is bilateral, total airway obstruction, aphonia and hoarseness of voice could be precipitated. Hence, it is wise for the operating surgeon to be guided by neural monitoring during thyroidectomy. We present a valuable experience handling a middle-aged man with a huge papillary thyroid carcinoma . He needed an urgent thyroidectomy due to obstructive symptoms. We highlight our intraoperative dexterity in handling his surgery in the context of continuous monitoring of RLN using electromyography.

  • anaesthesia
  • head and neck surgery
  • cancer intervention

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  • Contributors FFMI was the main author of this manuscript who was also involved in the comanagement of this patient with surgeon, NASNL. AJI and TBY were the anaesthetist in charge of this patient and contributed significantly to the main ideas of this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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