Blood and tissue levels of persistent organic pollutants and genetic susceptibility in patients with breast cancer.

We investigated possible associations between the internal concentrations of POPs and correlations between blood and tumor tissue concentrations in patients who underwent surgery for breast cancer and breast reduction as controls. Genetic variations in CYP1A1, GSTP1, GSTM1, and GSTT1 and hOGG1 were evaluated to determine whether they represent risk factors for breast cancer. Certain POPs have been found to be associated with breast cancer development. GST-P1 polymorphism represented a significant risk for breast cancer with unadjusted OR. However, the GSTT1 null polymorphism represented a significant risk for breast cancer when OR adjusted for age and smoking status. CYP1A1 polymorphism was a significant risk factor for breast cancer, regardless of whether the OR was adjusted. These results suggest that exposure to certain POPs, GSTT1 and CYP1A1 polymorphisms, age, and smoking status are risk factors for breast cancer. In addition, the blood concentrations of some POPs represent surrogates for breast tissue concentrations.

Complication and conversion outcomes in transoral endoscopic thyroidectomy vestibular approach (TOETVA): a retrospective multicenter propensity score-matched cohort study.

Transoral endoscopic thyroidectomy with vestibular approach (TOETVA) is a scarless thyroid surgery used as an alternative to open conventional surgery. Our aim was to investigate possible risk factors for complications and conversion during TOETVA. The study was conducted internationally by centres from Turkiye, the Republic of Korea, Italy, and Peru. A total of 406 patients who underwent TOETVA and were ≥ 18 years of age were included in the study. Demographic, pre-, intra-, and postoperative data were collected and compared between the groups with/without complication/conversion to identify possible predictors of complication/conversion. Subsequently, patients with complication/conversion were matched by the hospital, age, sex, and American Society of Anesthesiologists classification score using a propensity score (PSM) of 1:3 to eliminate confounding differences. Results were reported for the un-matched and matched groups. Complications occurred in 11 (2.7%) patients. High body mass index (26.4 ± 3.4 vs. 23.3 ± 3.7, p = 0.007), larger tumor size (1.7 ± 1.3 cm. vs. 1.1 ± 1.0 cm, p = 0.012), larger thyroid volume (20.0 ± 9.2 vs. 12.8 ± 8.5, p = 0.007) and long operation time (127.8 ± 45.0 min. vs. 97.7 ± 38.5 min., p = 0.008) were significantly associated with complications in un-matched analyses. Older age (42.7 ± 8.0 vs. 34.9 ± 9.2, p = 0.023), high BMI (26.7 ± 3.2 vs. 23.3 ± 3.7, p = 0.012), and longer operation time (160.1 ± 54.1 min. vs. 97.4 ± 37.8, p = 0.001) were significantly related to conversion in un-matched analyses. However, significance was lost after PSM for both complication and conversion. The data from this study conducted on TOETVA cases do not suggest a risk factor for complications and conversion with PSM.

Effects of microwave drying on physicochemical characteristics, microstructure, and antioxidant properties of propolis extract.

BACKGROUND: The heat sensitivity of phenolics and flavonoids leads to considerable losses of these compounds during conventional drying. Microwave drying has the advantage of shorter drying time and rigorous process control, minimizing damage to heat-sensitive compounds. Microwave drying kinetics and the impacts of microwave drying on physicochemical characteristics, morphological structure, antioxidant properties, total phenolics, and flavonoid content of propolis extract were investigated. RESULTS: Increasing the microwave power output from 180 to 900 W resulted in a 67% reduction in drying time. Morphological changes were more noticeable at higher microwave power levels as shown in scanning electron microscopy images. Water activity values of microwave dried propolis extracts were below 0.4, which satisfied the requirement for shelf-stable dry products. The solubility of microwave dried propolis extract increased with increasing microwave power level, and the highest solubility was achieved for the propolis extract microwave dried at 900 W. Microwave dried propolis extracts exhibited lower total phenolic content levels than fresh propolis extract. The microwave power level did not affect the total flavonoid content but it affected 2,2-diphenyl-1-picrylhydrazyl (DPPH) free-radical scavenging activity of microwave dried propolis extracts. The DPPH free-radical scavenging activity closest to the fresh propolis extract was obtained for the microwave dried propolis extract at 900 W. This also showed the highest 6-hydroxy-2,5,7,8-tetramethyl-2-carboxylic acid (Trolox) equivalent antioxidant capacity. CONCLUSION: Microwave drying of propolis extract at 900 W was found to be the most efficient drying condition because it yielded the shortest drying time, the highest effective moisture diffusivity, and phenolic and flavonoid content levels that were very similar to those in fresh propolis extract. © 2023 Society of Chemical Industry.

Hydrogen production using cocaine metabolite in microbial electrolysis cells.

In this study, the effects of cocaine metabolite, benzoylecgonine, commonly found in wastewater on hydrogen production were investigated using microbial electrolysis cells. Benzoylecgonine dissolved in synthetic urine and human urine containing benzoylecgonine were inoculated to evaluate hydrogen production performance in microbial electrolysis cells. Microbial electrolysis cells were inoculated with synthetic urine and human urine containing the cocaine metabolite benzoylecgonine for hydrogen gas production performance. Gas production was observed and measured daily by gas chromatography. GC-MS was used to analyze the compounds found in human urine before and after operation in microbial electrolysis cells. The metabolite's pH values and optical density in microbial electrolysis cells were analyzed spectrophotometrically. Hydrogen gas was successfully produced in microbial electrolysis cells (~ 5.5 mL) at the end of the 24th day in the presence of benzoylecgonine in synthetic urine. Human urine containing benzoylecgonine also generated hydrogen in microbial electrolysis cells. In conclusion, microbial electrolysis cells can be used to remove cocaine metabolites from contaminated wastewater generating hydrogen gas. Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-023-03805-7.

Evaluation of public's perception of scar cosmesis after thyroidectomy: results of a survey of Turkish versus South Korean individuals.

Purpose: Visible scars on the neck caused by thyroid surgery give rise to significant aesthetic, functional, and psychosocial problems. The objective of this study is to comparatively investigate the public perception of neck scar cosmesis in Turkish and South Korean populations. Methods: This survey was prepared to collect participants' demographic and socioeconomic data and determine their perception of scar cosmesis on the neck and consisted of 15 questions. One thousand thirty-nine individuals who did not undergo thyroid surgery completed the survey. The P-values of <0.05 were deemed to indicate statistical significance. Results: There were 1,039 respondents, of whom 525 (50.5%) were Turkish and 514 (49.5%) were South Korean. South Korean respondents stated that they would be significantly more uncomfortable with the thought of having a scar due to thyroid surgery, compared to the Turkish respondents (P < 0.001). The South Korean respondents stated that they would be significantly more concerned about the scar's length, thickness, and darkening color, compared to the Turkish respondents (P < 0.001 for all cases). Conclusion: Patients' expectations, which are affected by various sociodemographic factors and cultural characteristics, are as important as the medical condition when deciding on the type of thyroid surgery. The study findings clearly indicated that the South Korean population would be significantly more uncomfortable with having a scar on the neck, compared to the Turkish population. Therefore, in selected cases, a scarless thyroidectomy approach, such as transoral endoscopic thyroidectomy, vestibular approach may be preferable for societies like South Korea.

Video gaming improves robotic surgery simulator success: a multi-clinic study on robotic skills.

We aimed to investigate the effects of video game habits, duration of experience, and training in different surgical clinics on the success of robotic surgery simulators. In this prospective, observational, comparative, and multi-clinical study, all participants played Temple Run and Piano Tiles 2™ mobile games for 1 month, after answering a questionnaire including their sociodemographic characteristics, surgical experience, and past and current video game experience. At the end of the period, participants experienced four different robotic surgery simulator tasks (Camera Targeting 1, Energy Switching 1, Ring and Rail 2, Vertical Defect Suturing) in da Vinci® Skills Simulator™. Additionally, sociodemographic data were statistically analyzed with mobile game scores and 13 different performance scores obtained from the simulator. All robotic surgery simulator skill applications were carried out at Ege University Hospital in Izmir. All surgical residents in the general surgery, urology, and pediatric surgery clinics were included in the study. Sixty of the sixty-four participants in total completed all the processes. Four participants were excluded from the study. When clinical performances were compared, it was seen that the general surgery clinic performed better than other clinics in two parameters (overall score, time to complete) of the 'Camera Targeting' task (p = 0.01 and p = 0.006). Participants with mobile phone games experience were successful in the 'Energy Switching' task with less misapplied energy time (p = 0.039). Participants with high scores in Piano Tiles 2™ were more successful in the 'Energy Switching' task and completed the 'Ring Rail' task with fewer movements (p < 0.05). Participants with more surgical and laparoscopic surgery experience scored higher in the 'Camera Targeting' and 'Energy Switching' tasks and completed the assignments with less movement. Again, these participants completed the 'Vertical Defect Suturing' task faster and the 'Ring Rail' task with less movement. In addition, participants with more laparoscopy experience scored higher in the 'Ring Rail' task (p < 0.05). In this study, we showed the effect of recent gaming experience on robotic surgery abilities along with previous video game experience. For surgeons and surgeon candidates in robotic surgery training, the importance of video game-based learning techniques will increase when combined with rapidly developing simulation technologies.ClinicalTrials.gov Identifier: NCT05510960.

A Feasible Technique for Transoral Endoscopic Thyroidectomy Through Vestibular Access Using a Single-port Technique: A Video Vignette in Cadaver Dissection.

BACKGROUND: The aim of this study was to evaluate the safety and feasibility of a single-port system for transoral endoscopic thyroidectomy with vestibular access (TOETVA). MATERIALS AND METHODS: Two embalmed human cadavers were used to test the single-port technique. After positioning, a median vestibular incision was made. Adipose tissue was dissected through the mentum with a Kelly clamp to reach the subplatysmal level. The Keyport Single Port System (Richard Wolf) was then inserted. After port placement, flexible endoscopic dissectors and a 5-mm endoscope were advanced. After removing the dissectors, we inserted the ArtiSential laparoscopic instruments. We also used a 3-port TOETVA on another human cadaver to compare the results with those of the single-port surgery. RESULTS: In the first cadaver, skin tension was observed during trocar insertion and dissection. Trocar insertion resulted in skin perforation in the submental area. In the second cadaver, the single-port trocar was successfully inserted despite the significant skin tension. However, the trocar did not allow the necessary surgical maneuvers to proceed with subsequent surgical steps and create a working space. Postprocedural anatomic dissection revealed that the distal branches of the mental nerve were related to the trocar passage. CONCLUSIONS: Our cadaver study demonstrated that single-port TOETVA is unsafe and not feasible with the current technology of the Keyport single-port system. This approach needs to be improved to perform this technique without injury to distal branches of the mental nerve, skin perforation, and other complications.

Is the combined use of ultrasonography (USG) and fine needle aspiration biopsy (FNAB) safe in parotis masses? Retrospective comprehensive comparison of 123 cases.

OBJECTIVES: The purpose of the study was to compare final pathology results with ultrasonography (USI) and fine needle aspiration biopsy (FNAB) results in parotis masses. METHODS: A total of 123 patients with primary parotis mass who applied to our center between 2010 and 2020 were selected for the study. Among these, 100 patients with preoperative USI, preoperative FNAB, and postoperative final pathology were included in the study. USI, FNAB, pathology results, surgery types, and demographic characteristics of the patients were analyzed. RESULTS: According to the postoperative final pathology, preoperative USI sensitivity was found to be 100%, specificity was 55, positive predictive value was 84.31%, negative predictive value was 100%, and accuracy was 86.89%. Preoperative FNAB had a sensitivity of 85.7%, a specificity of 92.1%, a positive predictive value of 82.1%, a negative predictive value of 90.2%, and a diagnostic accuracy of 89.3%, according to the postoperative final pathology. CONCLUSION: Preoperative USI and preoperative FNAB are very valuable diagnostic tools in the evaluation of parotis lesions. When used together, they provide highly accurate and important data for the surgeon.

Intraoperative freehand SPECT as an alternative imaging technique for use in radioguided parathyroidectomy.

Freehand single photon emission computed tomography (fhSPECT) is a technique that is used to monitor body's radioactivity intraoperatively. Accordingly, in this study, the feasibility of using fhSPECT for intraoperative 3D mapping in radioguided parathyroidectomy has been assessed. Patients, who were diagnosed with primary hyperparathyroidism consecutively, were scanned intraoperatively using fhSPECT to locate parathyroid adenomas before surgical procedure. The fhSPECT images were acquired intraoperatively using a declipse®SPECT device (SurgicEyeTM). The fhSPECT protocol could not be completed due to the technical problems in one patient. Parathyroid adenoma was located in the first patient with no lateral deviation. Nevertheless, a deviation of 8 mm was detected in the depth of the parathyroid adenoma, which is the distance of parathyroid adenoma from the skin. A 20 mm lateral deviation and a 10 mm deviation in depth were detected in the second patient. In the third patient, as was the case in the first patient, parathyroid adenoma was located with no lateral deviation. However, there was a 15 mm deviation in the depth of the parathyroid adenoma. A 5 mm lateral deviation was detected in the fourth patient yet with no deviation in the depth of parathyroid adenoma. Finally, neither lateral nor vertical deviation was detected in fifth patient. Based on the findings of this study, it was concluded that the fhSPECT technology can be helpful to a certain degree in locating the parathyroid adenoma. However, further studies are needed to support the findings of this preliminary study.

Modified Larssen solution (MLS)-fixed cadaver model for transoral endoscopic thyroidectomy vestibular approach (TOETVA) education: a feasibility study.

BACKGROUND: Training formats for transoral endoscopic thyroidectomy vestibular approach (TOETVA) are limited. Our aim was to create and investigate a TOETVA training model for general and ENT surgeons. METHODS: A total of 15 modified Larssen solution (MLS) human cadavers were used in the study. A day duration TOETVA human cadaver workshops were offered in two years consecutive. Post-training verbal and online questionnaires were applied to all trainers to evaluate course structure and program, organoleptic characteristics of MLS-fixed human cadavers, and TOETVA training effectiveness. Cost assessment is included in the study. RESULTS: Ninety-eight participants, i.e., 14 trainers and 84 hands-on (HO) and observer (OB) trainees, attended the workshops, completed the tasks assigned, and fulfilled the questionnaires. Implementation of all steps of TOETVA was approved positively by 89.8% of all participants, 94.4% of HO, and 83.3% of OB trainees. Regarding human cadaver and teaching quality, 10.8 ± 0.8 (10-12) human cadavers were "practical" by 13.2 (94.5%) of the trainers, and by 33.3 (92.5%) of the trainees for all steps of TOETVA. The cadavers were stored for 4.53 years and used 6.27 times repeatedly for endoscopic workshops and research studies. TOETVA workshop cost with repeatable use of MLS-fixed human cadaver is half of other performed TOETVA workshops. CONCLUSIONS: A TOETVA human cadaver workshop model has not been reported yet. Our findings suggest the feasibility of MLS-fixed human cadaver model for training of TOETVA, preserve the organoleptic properties necessary for the implementation of surgical steps, and reduce the cost.

Transoral endoscopic thyroidectomy vestibular approach (TOETVA): A novel surgical technique for scarless thyroidectomy in pediatric surgery.

Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a novel surgical technique in thyroid surgery that provides a feasible opportunity to avoid a visible neck scar. In recent years, TOETVA became popular in the thyroid surgery of selected adult patients with cosmetic concerns. We conducted a right lobectomy with the TOETVA technique in a 17-year-old adolescent with a suspicious thyroid nodule the present report aimed to describe the details of the operative technique step by step. Level of evidence: LEVEL IV, case series with no comparison group.

Composite pheochromocytoma with spindle cell sarcoma - a rare tumor of the adrenal gland: case report.

Composite pheochromocytomas with a non-pheochromocytoma component stemming from an embryological origin other than the neural crest comprise a unique entity. We present a patient diagnosed with a composite pheochromocytoma with spindle cell sarcoma, which is, to our knowledge, the first case reported in the current literature. A 45-year-old female patient with elevated blood pressure had undergone adrenalectomy for clinically and radiologically diagnosed pheochromocytoma. Macroscopic examination of the specimen showed an encapsulated mass containing two nodules. One tumor was composed of large polygonal neoplastic cells with round vesicular nuclei and granular cytoplasm forming the characteristic Zellballen pattern consistent with pheochromocytoma, while the other was composed of spindle cells with hyperchromatic nuclei and prominent nucleoli, thus resembling a sarcoma. The patient was discharged on the fourth post-operative day without any complications. Even though for both tumors surgical resection is the main treatment modality, our case report aims to shed light on and discuss the etiology and management of a rarely presented composite pheochromocytoma and spindle cell sarcoma.

Transoral endoscopic parathyroidectomy vestibular approach (TOEPVA) for primary hyperparathyroidism: Turkey's experience.

AIM: Parathyroid surgery has witnessed a significant evolution with the introduction of more efficacious preoperative localization imaging techniques and the use of rapid intraoperative parathormone assays. Parathyroid surgery can now be performed with the minimum of invasion. Through the adaptation of the transoral endoscopic thyroidectomy vestibular approach (TOETVA), the technique has now been adopted for parathyroid surgery, known as the transoral endoscopic parathyroidectomy vestibular approach (TOEPVA). We present here the initial experiences of 11 centers carrying out TOEPVA surgery in Turkey. MATERIALS AND METHODS: Participating in the study were 11 centers, all of which were tertiary care institutions carrying out endocrine surgery. A retrospective review was made of 35 primary hyperparathyroidism patients who underwent the TOEPVA procedure between July 2017 and January 2020. RESULTS: Of the total 35 patients, 32 patients underwent the TOEPVA procedure successfully. All patients but one were female, and the mean age was 47.2 (20-73) years. According to localization studies, 18 of the lesions were lower left, 12 were lower right, 3 were upper right and 2 were upper left. The mean operative time was 116 (30-225) min, and three cases were converted to an open procedure. Simultaneous thyroidectomy was performed in seven cases. The average PTH level dropped to normal within 20 min. after the resection in all cases. The complication rate was 19% (ecchymosis, subcutaneous emphysema, nasal bleeding, surgical site infection and seroma). There were neither recurrent nerve palsies, nor mental nerve root or branch injuries. The average hospital stay was 1 day. No persistence was documented on follow up. CONCLUSION: TOEPVA is a "hidden scar" parathyroidectomy procedure that can be safely performed on parathyroid adenomas, in cases that have scar-related concerns. Having its own procedure-related complications, the procedure provides satisfactory objective results, particularly in centers experienced in endoscopic and endocrine surgery.

Health-Related Quality of Life After Nipple-Sparing Mastectomy: Results From the INSPIRE Registry.

INTRODUCTION: Nipple-sparing mastectomy (NSM) with immediate breast reconstruction (IBR) is increasingly used for both breast cancer (TNSM) and risk reduction (RRNSM). The aim of the study is to report the results of the INSPIRE registry assessing health-related quality of life (HRQoL) comparing baseline and 1-year follow-up, regarding surgical indications and chemotherapy (CT) received. METHODS: INSPIRE is a prospective database including women undergoing NSM and IBR from 18 countries. HRQoL was measured using EORTC QLQC30 and QLQ-BR23 before surgery and after 1 year. RESULTS: A total of 677 women were included, of whom 537 (79.3%) underwent TNSM and 140 (21.6%) RRNSM: in total, 806 NSM (556 TNSM and 250 RRNSM). Nipple involvement was present in 7.73% of TNSM and incidental carcinoma in 1.2% of the RRNSM group. Out of the overall 537 patients with systemic treatment, 177 (32.96%) received neoadjuvant chemotherapy (NCT) and 118 (21.92%) adjuvant chemotherapy (CT). A total of 227 patients (28.16%) developed at least one complication postoperatively, 164 (29.5%) in the TNSM group and 63 (25.2%) in the RRNSM group. The TNSM group improved in global health status and emotional functioning after 1 year. No differences were found when comparing HRQoL at 1 year between patients who received NCT and those who received adjuvant CT. The RRNSM group showed improvement in HRQoL, with better emotional functioning and fatigue after 1 year. CONCLUSIONS: This registry reports HRQoL findings after NSM. The impact of CT on worse HRQoL is independent from its timing. Patients with RRNSM showed an improved HRQoL at 1-year follow-up. Discussion of HRQoL outcomes with patients will facilitate the informed decision-making when considering NSM.

Pharmacokinetic study of clarithromycin in human breast milk by UPLC-MS/MS.

This study aimed to develop a validated UPLC-MS/MS method for pharmacokinetic analysis of clarithromycin in human breast milk. For sample preparation, proteins precipitated with methanol and azithromycin were used as internal standards. Clarithromycin and azithromycin detection was achieved using electrospray ionization in positive mode. The chromatographic separation time was 5 min. The lower limit of quantification was 50 ng/mL. The calibration curve of clarithromycin was 50-4000 ng/mL, with a correlation coefficient> 0.99. The method was successfully applied to determine clarithromycin levels in breast milk obtained from a lactating mother after oral administration of a single tablet containing 500 mg of clarithromycin. The maximum human breast milk concentration (Cmax) was 3660 ng/mL, the time to reach the maximum concentration (tmax) was 2.5 h, and the area under curve (AUC0-24) was 18450 ng h/mL. The present study provides a novel UPLC-MS/MS method for pharmacokinetic analysis of clarithromycin in breast milk.

Cecal duplication cyst causing ileus: A rare pediatric case report.

Duplication cysts are one of the rare congenital anomalies of the gastrointestinal tract. Although it can be seen at all levels throughout the gastrointestinal tract, it is most common in the ileum. One of the rarest of duplication cysts is cecal duplication cyst. Clinically, they become present in the form of vomiting, distention, abdominal pain and palpable mass. Rarely, it can cause acute abdomen such as perforation and obstruction. We present a case of cecal duplication cyst requiring urgent surgical treatment that causes obstruction in a 3-month-old baby.

Patient Eligibility for Transoral Endoscopic Thyroidectomy Vestibular Approach in an Endemic Region.

OBJECTIVE: Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a scarless method that enables thyroidectomyusing natural orifice of the body. The opinion which is even common among TOETVA performing surgeons is that this surgery involves a small percentage of thyroidectomy applied patients. In this study, based on the currently accepted exclusion criteria, we aimed to determine what percentage of patients, who underwent thyroidectomy in an endemic area are actually suitable for TOETVA. METHODS: Between January 2017 and December 2019, 1197 consecutive patients who underwent surgery for thyroid pathology in our clinic were analyzed retrospectively. Pre-operative evaluations were made according to the current exclusion criteria and as a result, patients with no previous neck surgery, no history of radiotherapy, no retrosternal thyroid extension, and none lymph node dissection operation been made and whose thyroid gland diameter is <10 cm and gland volume is not more than 45 ml, malignant nodule diameter is <2 cm, and benign nodule diameter is <4 cm are involved to this study by being considered appropriate for TOETVA procedure. RESULTS: According to the criteria, 513 patients (42.8%) were found suitable for TOETVA. A total of 421 (82%) of these patients were female and 92 (18%) were male. The mean age was 46.2±13.2. A total of 192 (37%) of these patients were operated due to the benign reasons, and 321 (63%) of these patients operated due to the malignancy or suspicion of malignancy. Average nodule size was 1.9 cm, and the average thyroid volume was 23.8 ml among benign patients. Whereas among malignant patients, the average nodule size was 1.7 cm and the average thyroid volume was 21.8 ml. A total of 462 (90.1%) of the patients were applied to the total thyroidectomy and 51 (9.9%) of the patients were applied to the hemithyroidectomy. In the same period, 29 patients operated through TOETVA and 4 patients operated through bilateral axillary breast approach thyroidectomy. When the final pathology, results of the patients were examined, papillary thyroid carcinoma was seen in 301 (58.7%) patients, benign pathologies were seen in 192 (37.4%) patients, and 20 (3.9%) patients were diagnosed with other pathologies (follicular thyroid carcinoma, poorly differentiated carcinoma and Hürthle cell neoplasia, etc.). CONCLUSION: Although "patient willingness" factor could not be included in the study, TOETVA eligible patient repository is wider contrary to popular belief. In our humble opinion, TOETVA method is going to pursue its spread and become a part of the routine surgical training session due to its effectiveness in terms of credibility in today's world where cosmetic concerns gradually gain prominence.

Comparison of Monopolar and Bipolar Stimulator Probes for Intraoperative Nerve Mapping During Thyroidectomy: A Prospective Study.

OBJECTIVES/HYPOTHESIS: During intraoperative neuromonitoring in thyroid surgery, two different kinds of stimulator probes, monopolar and bipolar, are commonly used to stimulate the laryngeal nerves. We explore the unique characteristics of both of these probes as they relate to intraoperative laryngeal nerve mapping. METHODS: Twenty-one patients undergoing neuromonitored thyroidectomy by a single surgeon were enrolled. Electromyography (EMG) amplitude and latency measurements were prospectively recorded concurrently from 1 mA stimulation of vagus nerve (VN) and inferior/superior recurrent laryngeal nerve before (with and without fascia) and after thyroid resection using bipolar and monopolar stimulator probes. RESULTS: Significantly higher amplitudes were obtained with monopolar stimulator probes as compared to bipolar probes, in several stimulation scenarios such as at right VN pre-resection (carotid sheath intact), right VN pre-resection (carotid sheath dissected), right VN post-resection and left VN (carotid sheath dissected). No significant differences were found between amplitudes and latency values in all other stimulation scenarios. CONCLUSIONS: According to this study, both probes are reliable and safe for neural mapping. The kind of probe used during neural monitoring is based on surgical situations and surgeon preference. LEVEL OF EVIDENCE: 3 (According to Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence) Laryngoscope, 131:E2718-E2726, 2021.