Prognostic value of subthreshold biphasic electromyographic (EMG) waveforms in Type I loss of signal during thyroid intraoperative neuromonitoring

In cases of Type I LOS during thyroid surgery, the presence of subthreshold biphasic EMG waveforms may reflect residual neural conduction and is strongly associated with postoperative vocal fold recovery. These findings suggest that optimization of threshold settings can improve the sensitivity of IONM interpretation and assist in intraoperative prognostic assessment.