Healthcare Professionals

APS™ Continuous Monitoring Electrodes

Intraoperative Neuromonitoring Accessories



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Why Use APS™ Continuous Monitoring Electrodes?

Injury to the recurrent laryngeal nerve (RLN) is one of the most serious complications of thyroid surgery. Yet research shows the rate of RLN damage is underestimated.1-5

In between stimulations, nerves can be at risk due to surgical incision, "blind" trauma caused by stretching or manipulation during tumor/thyroid removal, and cumulative trauma or damage that may result in neuropraxia.

Used with a NIM™ nerve monitoring system, the Automatic Periodic Stimulation™ (APS) continuous monitoring electrode enables early detection and warning of a change in nerve function. This allows the surgeon to take immediate corrective action to prevent potential injury.6,7 The APS™ electrode is placed on the vagus nerve and delivers continuous low-level stimulation. A baseline of nerve function is obtained, and subsequent EMG responses are monitored and charted in real time to provide feedback.


Lo C, Kwok F, Yuen P. A prospective evaluation of recurrent laryngeal nerve paralysis during thyroidectomy. Archives of Surgery 2000;135(2): 204-207.


Dionigi G, et al. The technique of intraoperative neuromonitoring in thyroid surgery. Surg Technol Int. 2010;19: 25-37.


Randolph GW. Surgery of the Thyroid and Parathyroid Glands. Chapter 25: Surgical Anatomy of the Recurrent Laryngeal Nerve (p316). Elsevier Science (USA), 2003.


Bergenfelz A, Jansson S, Kristoffersson A. Complications of thyroid surgery: results as reported in a database from a multicenter audit comprising 3,660 patients. Langenbecks Arch Surg. 2008; 393: 667-673.


Ready AR, Barnes AD. Complications of thyroidectomy. Br J Surg. 1994; 81: 1555-1556.


Schneider R, Randolph GW, Sekulla C, et al. Continuous intraoperative vagus nerve stimulation for identification of imminent recurrent laryngeal nerve injury. Head and Neck 2012; doi :10.1002/hed.23187.


Van Slycke S, Gillardin J-P, Brusselaers N, Vermeersch H. Initial experience with S-shaped electrode for continuous vagal nerve stimulation in thyroid surgery. Langenbecks Arch Surg. doi: 10.1007/s00423-013-1068-3. Epub 2013 Mar 5.


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