COBRA 3-PLATE Universal EMG Endotracheal Tube
Reliable intraoperative nerve monitoring of the RLN.
Cobra 3-Plate EMG ET tube delivers enhanced neuromonitoring of the vocal cords while maintaining an open airway. Neurovision Medical Products redesigned the patented EMG electrode to improve a surgeon's ability to identify the recurrent laryngeal nerve and reduce the risk of nerve injury during Thyroid surgery.
The Cobra 3P EMG ET tube is compatible with any nerve monitoring system.
The new design features three EMG electrodes that reach optimal depth and improve contact with vocal folds for reliable EMG signals. NMP conductive silver ink electrodes reduce trauma to the airway.¹
Cobra® EMG Endotracheal Tube for Intraoperative Monitoring
|Item Code||Product Description*|
|LTE7003PS-5||Cobra 3-Plate EMG Endotracheal Tube, 6 mm|
|LTE7003PM-5||Cobra 3-Plate EMG Endotracheal Tube, 7 mm|
|LTE7003PL-5||Cobra 3-Plate EMG Endotracheal Tube, 8 mm|
*each EMG ET tube kit includes a STIM return needle and a ground needle
Atraumatic EMG Electrodes
Neurovision Medical Products patented atraumatic EMG electrodes for safe, continuous RLN monitoring.¹
Conductive silver ink EMG plates are durable and flexible for reliable nerve activity detection. The smooth surface electrodes have zero-profile* and are atraumatic to the airway.
The standard PVC endotracheal tube integrated with EMG electrodes a proven safe and effective for prolonged, continuous monitoring during surgery.
*Silver ink EMG electrode has a non-measurable height and cannot be assigned a value.
Universal RLN Monitoring
Cobra 3P universal design is compatible with single-channel and multi-channel nerve monitoring systems.
Increased electrode size improves contact with the vocal cords, even in longer airways or larger patients.
The top-of-the-line RLN electrode features 1.5 mm touch-proof connectors with color-coded wires that identify the lateral and posterior plates.
Cobra 3P EMG ET tube has multiple features that enhance intraoperative neuromonitoring performance.
A high volume, low-pressure cuff, improves the air seal on the trachea.
The electrode and wire integration is hermetically sealed to prevent fluids from disrupting the EMG signal and reduce unwanted functional issues. All lead wires use a standard DIN (42802) plug for an easy and secure connection to any nerve monitoring system.
The innovative NEW design with patented technology creates a truly universal intraoperative neuromonitoring EMG tube with an enhanced IONM performance overall.
Frequently Asked Questions
Yes, Cobra 3P is fully compatible with any IOM nerve monitoring system. Cobra 3P features color-coded leadwires with standard DIN (42802) connectors for an easy set-up on single-channel and multi-channel systems.
Cobra 3P EMG ET tubes are available in 6mm, 7mm, and 8mm. The patented EMG technology is integrated onto standard PCV endotracheal tubes and the low (almost zero) profile electrodes do not impact the tube size.
Cobra 3P is used in procedures where the recurrent laryngeal nerve (RLN) is at risk of injury; e.g. thyroidectomy, parathyroidectomy, ACDF. Cobra 3P EMG endotracheal tubes are intended to provide two essential functions; IOM EMG monitoring of vocal cord (laryngeal musculature) activity while maintaining an open airway for the patient during surgery.
No, intubation with a Cobra 3P should follow the current medical techniques with the recommendation of using a Glidescope. Once the endotracheal tube is placed the electrode plates should maintain direct contact with the vocal cords. When using the Cobra 3P, avoid scraping the electrodes during intubation. Otherwise, electrode damage from this can impede accurate EMG signals. Once intubated the EMG endotracheal tube should be secured in a midline position, a side rotation is not recommended.
Cobra 3P is similar to most EMG ET tubes, like the Cobra 2-Ch the solid red and blue lead wires correlate to the lateral electrodes (right and left) but the unique difference is that the 3rd electrode is connected to two lead wires (red/white & blue/white) creating a singular posterior reference electrode. This design optimizes the EMG response by maximizing the area covered by the electrodes and produces redundant monitoring of the vocalis muscles if tube rotation is inadvertently experienced.
No, the electrodes have been enhanced in length and symmetry improving the target area. The glottic markings are no longer needed but the depth markings (18 – 24 cm) are present.
Yes, the Cobra 3P has the longest electrode plates of any EMG ET tube on the market allowing it to accommodate large patients and longer airways. To assist in accurate depth placement the 18-24 cm depth markings are visible on the ET tube.
No, although the new electrode geometry is designed to reduce alignment sensitivity, it is recommended that Cobra 3-Plate be aligned and maintained to the middle of the pharynx and positioned with the red wire on the right and the blue wire on the left. This position creates the proper right/left contact between the vocal cords and its respective electrode/plate.
1. Rea, James L. Blakely, Stephen W. Electrode for prolonged monitoring of laryngeal electromyography. US 20110071379 A1, United States Patent and Trademark Office, 24 March 2001. USPTO Database: bit.ly/3FnTT0L
2. Chiu, Peter et al.(2021) "Aortic elongation and bronchial splint for late bronchial complication after neonatal arch reconstruction."JTCVS Techniques, Volume 8, 126 - 128. doi.org/10.1016/j.xjtc.2021.04.014
3. Hodnett, Benjamin L et al. “Superior laryngeal nerve monitoring using laryngeal surface electrodes and intraoperative neurophysiological monitoring during thyroidectomy.” Clinical anatomy (New York, N.Y.) vol. 28,4 (2015): 460-6. doi:10.1002/ca.22487 pubmed.ncbi.nlm.nih.gov/25425500/