Healthcare Professionals


Nerve Monitoring Systems

Related Nerve Monitoring Products

Our nerve monitoring products and accessories can be used in conjunction with NIM® Nerve Monitoring Systems during a variety of surgical procedures. These include ENT surgeries, such as otologic procedures and thyroidectomies, as well as other operations performed by endocrine, general, and peripheral surgeons.

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Endotracheal Tubes

NIM EMG Endotracheal Tubes

NIM EMG Endotracheal Tube for Nerve Monitoring in Thyroid Surgery

NIM TriVantage Tube with cross-band to guide placement

Why Use a NIM EMG Tube?

Even experienced surgeons find it difficult to visually identify the recurrent laryngeal nerve (RLN) or vagus nerve during thyroid surgery and other neck dissections. Studies show that the rate of RLN injury is under-estimated1-6 and intraoperative nerve monitoring of the RLN is recommended as a risk-minimizing tool.1-4,7-15

NIM® EMG Tubes provide an open airway for patient ventilation and intraoperative nerve monitoring of both vocal cords. If nerve function changes, the NIM System alerts you with visual and audible warnings to help reduce the risk of patient injury.

NIM TriVantage EMG Tube

The NIM TriVantage® EMG Tube is a standard size, non-reinforced, DEHP-free PVC tube that features smooth, conductive silver ink electrodes and a cross-band to guide placement. It has reduced sensitivity to rotation and movement while offering increased EMG responses that facilitate improved nerve dissection.

Together with the NIM System, a properly positioned NIM EMG Tube can reduce the risk of injury to your patient by helping you to:

  • Identify the recurrent laryngeal or vagus nerves
  • Control manipulation during dissection
  • Verify the integrity of the nerve prior to surgical closure

Only NIM EMG Tubes are tested and validated for use with NIM nerve monitors.

Surgical Applications for NIM EMG Endotracheal Tubes

  • Carotid endarterectomy
  • Cricopharyngeal myotomy
  • Excision of Zenker’s diverticulum
  • Hemithyroidectomy
  • Neck biopsy
  • Neck dissection
  • Parathyroidectomy
  • Partial laryngectomy
  • Substernal goiter
  • Thyroidectomy



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.


Dionigi G, et al. Why monitor the recurrent laryngeal nerve in thyroid surgery? J Endocrinal Invest. 2010; 33: 819-822.


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.


Randolph GW and Dralle H with the International Intraoperative Monitoring Study Group. Electrophysiologic recurrent laryngeal nerve monitoring during thyroid and parathyroid surgery: international standards guideline statement. Laryngoscope 2011; 121:S1-S16.


Dralle H. Intraoperative monitoring of the recurrent laryngeal nerve in thyroid surgery.World J Surg. 2008 32(7): 1358-1366. This article received the World Journal of Surgery award for Best Paper in 2008 and identifies risk-minimizing tools to help avoid recurrent laryngeal nerve palsy.


Thomusch O, Sekulla C, Walls G, Machens A, Dralle H. Intraoperative neuromonitoring of surgery for benign goiter. Amer J Surg. 2002;183(6): 673–678.


Dralle H, Sekulla C, Haerting J, Timmermann W, Neumann HJ, Kruse E, Grond S, Mühlig HP, Richter C, Voß J, Thomusch O, Lippert H, Gastinger I, Brauckhoff M , Gimm O. Risk factors of paralysis and functional outcome after recurrent laryngeal nerve monitoring in thyroid surgery. Surgery. 2004;136:1310–1322.


Eisele DW. Intraoperative electrophysiologic monitoring of the recurrent laryngeal nerve. Laryngoscope. 1996;106: 443–449.


Chiang F-Y, Lu I-C, Chen H-C, Chen H-Y, Tsai C-J, Hsiao P-J, Lee K-W, Wu C-W. Anatomical variations of recurrent laryngeal nerve during thyroid surgery; how to identify and handle the variations with intraoperative neuromonitoring. Kaohsiung J Med Sci. 2010; 26(11): 575-583.


Chiang FY, et al. Intraoperative neuromonitoring for early localization and identification of recurrent laryngeal nerve during thyroid surgery. Kaohsiung J Med Sci. 2010; 26(12): 633-638.


Chiang FY, et al. Standardization of intraoperative neuromonitoring of recurrently laryngeal nerve in thyroid operation. World J Surg 2010; 34(2): 223-229.


Dralle H, et al. What benefits does neuromonitoring bring to thyroid surgery? Artz und Krankenhaus. 2004; 369-376.

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