목적: Most important postoperative complication may be the impairment of vocal cord mobility. Therefore, electromyographic (EMG) endotracheal tube have been used to prevent this complication. The aim of the study is to evaluate the efficiency of intraoperative neuromonitoring using EMG tube by comparing voice outcome between patients who underwent thyroid surgery with and without EMG tube. 방법:Two hundred ninety four patients who underwent thyroid surgery from September 2013 to December 2014 were reviewed. The exclusion criteria included preoperative vocal cord paralysis or other lesions, sacrificed recurrent laryngeal nerve, short follow-up period. Total 210 patients underwent voice analysis before and after thyroidectomy. 결과:Total 210 patients (EMG group 102, no EMG group 108) were enrolled in this study. Demographics, age, gender, surgery type and the preoperative voice profiles of two groups were not significantly different and there no significant difference of vocal cord paralysis prevalence between two groups. Even if F0 , jitter, shimmer, NHR change after thyroid surgery showed no significant difference between two groups, voice range profile (VRP) for high pitch and low intense of EMG group showed significant better outcome than that of no EMG group (p<0.001) at both 1 week and 1 month after operation. 결론:The group with intraoperative neuromonitoring using EMG tube showed a better outcome in VRP after surgery. Even if the comparison of voice outcome between two groups may be needed for longer duration, EMG tube may be a useful instrument to reduce dysphonia after thyroid surgery.