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thyroid superior laryngeal nerve

Beata Wojtczak, Marcin Barczyński
Reoperative thyroid surgery is still challenging even for skilled surgeons, and is associated with a higher incidence of complications, such as hypoparathyroidism and recurrent laryngeal nerve (RLN) palsy. Displacement of the RLN, scar tissue from previous neck surgery and difficulty in maintaining good hemostasis are risk factors in reoperations. The prevalence of RLN injury in reoperative thyroid surgery ranges as high as 12.5% for transient injury and up to 3.8% for permanent injury. Bilateral paresis can also occur during reoperations, and is a dangerous complication influencing the quality of life, sometimes requiring tracheostomy...
October 2016: Gland Surgery
Samuel R Barber, Whitney Liddy, Natalia Kyriazidis, Matteo Cinquepalmi, Brian M Lin, Rahul Modi, Stephanie Patricio, Dipti Kamani, Carlo Belotti, Sadhana Mahamad, Bradley Lawson, Gregory W Randolph
OBJECTIVES/HYPOTHESIS: During intraoperative neural monitoring (IONM) in thyroid and parathyroid surgery, endotracheal (ET) tube migration can result in a decrease in vocalis electromyographic (EMG) amplitude without a concordant latency elevation during stimulation of the recurrent laryngeal nerve (RLN). STUDY DESIGN: Retrospective review. METHODS: Data were reviewed retrospectively for thyroid and parathyroid surgery patients with IONM of the laryngeal nerves from January 2015 to December 2015...
November 16, 2016: Laryngoscope
Mehmet Uludag, Nurcihan Aygun, Adnan Isgor
Classical understanding of the function of the pharyngeal plexus in humans is that it relies on both motor branches for innervation of the majority of pharyngeal muscles and sensory branches for the pharyngeal wall sensation. To date there has been no reported data on the role of the pharyngeal plexus in vocal cord innervation. The aim of this study is to evaluate whether or not the plexus pharyngeus contributes to the innervation of the vocal cords. One hundred twenty-five sides from 79 patients (59 female, 20 male) undergoing thyroid surgery with intraoperative neuromonitoring were prospectively evaluated...
November 3, 2016: European Archives of Oto-rhino-laryngology
Seo Ki Kim, Jung-Woo Woo, Inhye Park, Jun Ho Lee, Jun-Ho Choe, Jung-Han Kim, Jee Soo Kim
PURPOSE: The da Vinci surgical robot system was developed to overcome the weaknesses of endoscopic surgery. However, whether robotic surgery is superior to endoscopic surgery remains uncertain. Therefore, the purpose of this study was to compare the surgical and oncologic outcomes between endoscopic and robotic thyroidectomy using bilateral axillo-breast approach (BABA). METHODS: Between January 2008 and June 2015, papillary thyroid carcinoma patients who underwent thyroidectomy with central neck dissection using endoscopic (n = 480) or robotic (n = 705) BABA were primarily reviewed...
October 24, 2016: Langenbeck's Archives of Surgery
Kara Marie Hessel, Erich Wessel, Anthony Olinger, Barth W Wright
BACKGROUND: This study aimed to identify the Anterior and Posterior Extralaryngeal branches (AELB, PELB) of the Recurrent Laryngeal Nerve (RLN), measure these branches when present, and determine relationships between gender, sidedness and neck length. MATERIALS AND METHODS: Dissection was completed to level of the thyroid on 45 cadavers. The course of the RLN was then traced superiorly from its entry into the neck. Careful reflection of the thyroid and dissection of the lateral thyroid ligament permitted visualization of the full course of the nerve...
September 26, 2016: Folia Morphologica (Warsz)
Ivy H Gardner, Gerard M Doherty, David McAneny
PURPOSE OF REVIEW: Laryngeal nerve injury, resulting in speech and swallowing dysfunction, is a feared complication of thyroid operations. Routine visualization of the recurrent laryngeal nerve (RLN) has decreased the likelihood of nerve injury, and intraoperative nerve monitoring has been applied in the hope of further enhancing safety. RECENT FINDINGS: There is conflicting evidence about the value of nerve monitoring during thyroid operations, despite ample research...
October 2016: Current Opinion in Endocrinology, Diabetes, and Obesity
Whitney Liddy, Samuel R Barber, Matteo Cinquepalmi, Brian M Lin, Stephanie Patricio, Natalia Kyriazidis, Carlo Bellotti, Dipti Kamani, Sadhana Mahamad, Henning Dralle, Rick Schneider, Gianlorenzo Dionigi, Marcin Barczynski, Che-Wei Wu, Feng Yu Chiang, Gregory Randolph
OBJECTIVES/HYPOTHESIS: Correlation of physiologically important electromyographic (EMG) waveforms with demonstrable muscle activation is important for the reliable interpretation of evoked waveforms during intraoperative neural monitoring (IONM) of the vagus nerve, recurrent laryngeal nerve (RLN), and external branch of the superior laryngeal nerve (EBSLN) in thyroid surgery. STUDY DESIGN: Retrospective chart review. METHODS: Data were reviewed retrospectively for thyroid surgery patients with laryngeal nerve IONM from January to December, 2015...
July 4, 2016: Laryngoscope
Che-Wei Wu, Xiaoli Liu, Marcin Barczyński, Hoon Yub Kim, Gianlorenzo Dionigi, Hui Sun, Feng-Yu Chiang, Dipti Kamani, Gregory W Randolph
OBJECTIVES: To compare electromyography (EMG) characteristics of the external branch of superior laryngeal nerve (EBSLN), recurrent laryngeal nerve (RLN), and vagus nerve (VN) evoked with different stimulation probes/dissectors during monitored thyroid surgery. STUDY DESIGN: Experimental porcine model. METHODS: In five piglets (10 EBSLNs/RLNs/VNs), laryngeal EMG was recorded by endotracheal tube surface electrodes with stimulation using five monopolar probes (group I), three bipolar probes (group II), and two stimulation dissectors (group III)...
July 1, 2016: Laryngoscope
Miroslav Tedla, S Chakrabarti, M Suchankova, M O Weickert
Voice symptoms are frequently reported early after thyroidectomy, even in the absence of laryngeal nerves injury. We evaluated the short-term outcomes of these functional alterations. Thirty-nine patients were enrolled in a prospective observational trial, evaluating voice function before and 3 months after uncomplicated thyroidectomy, using VoiSS as assessed using a validated patient rated questionnaire; and perceptual voice analysis using GRBAS scale (Grade, Roughness, Breathiness, Asthenia, Strain). Impact of dysphonia on patient's life using VoiSS questionnaire revealed differences between pre- and postoperative assessment...
June 23, 2016: European Archives of Oto-rhino-laryngology
Wen-Chun Tseng, Yu-Cheng Pei, Alice M K Wong, Hsueh-Yu Li, Tuan-Jen Fang
BACKGROUND: Iatrogenic trauma induced by thyroid surgery is the most common etiology of unilateral vocal fold paralysis (UVFP). UVFP after thyroid surgery may lead to profound physical and psychosocial distress. This study comprehensively evaluated UVFP caused by thyroid surgery, and compared the results with those caused by other surgical trauma. METHODS: Patients with surgery-related UVFP were evaluated using quantitative laryngeal electromyography, videolaryngostroboscopy, voice acoustic analysis, the Voice Outcome Survey, and the Short Form-36 Health Survey quality-of-life questionnaire...
July 2016: Thyroid: Official Journal of the American Thyroid Association
Jane Lee, Sheila Fraser, Anthony Glover, Stan Sidhu
BACKGROUND: The use of routine intraoperative neuromonitoring (IONM) is controversial in thyroid surgery. Guidelines have been published to standardize IONM. This study examines the impact of routine IONM on a high-volume thyroid surgeon. METHODS: A prospective study was conducted using IONM between May 2013 and December 2014. Demographics, type of operation, pathology, recurrent laryngeal nerve (RLN) and external branch of the superior laryngeal nerve (EBSLN) visualization and sub-type classification, cricothyroid or cricopharyngeal twitch/electrode depolarization were obtained, and complications were recorded...
April 18, 2016: ANZ Journal of Surgery
Shun-Ichi Chitose, Kiminori Sato, Mioko Fukahori, Shintaro Sueyoshi, Takashi Kurita, Takeharu Ono, Buichiro Shin, Ryota Mihashi, Hirohito Umeno
OBJECTIVES/HYPOTHESIS: Transoral laser microsurgery (TLM) for hypopharyngeal cancer results in a lower incidence of complications than conventional open surgery. However, additional knowledge regarding the histoanatomical characteristics of the hypopharynx is necessary to prevent severe complications during TLM. The purpose of this study is to investigate the histoanatomical characteristics of the hypopharynx for TLM. STUDY DESIGN: Histoanatomical study. METHODS: Whole organ serial sections of three hypopharynges and larynges from autopsy cases were subjected to hematoxylin & eosin and Elastica van Gieson staining...
August 2016: Laryngoscope
Asit Arora, George Garas, Sunil Sharma, Keerthini Muthuswamy, James Budge, Fausto Palazzo, Ara Darzi, Neil Tolley
INTRODUCTION: Transaxillary robotic thyroid surgery was pioneered in South Korea where cultural factors, anthropometry and remuneration favour this. Small thyroid nodules account for the majority of cases due to a national thyroid cancer screening programme. However, the technique has not been evaluated in the United Kingdom where larger thyroid nodules tend to undergo surgery in a patient population with a higher body mass index (BMI). METHODS: Long term prospective non-randomised study...
March 2016: International Journal of Surgery
Yann-Sheng Lin, Hsin-Yi Wu, Chao-Wei Lee, Chih-Chieh Hsu, Tzu-Chieh Chao, Ming-Chin Yu
BACKGROUND: When to use a thoracic approach to treat substernal goitres has often been discussed in the literature. But there are few published reports describing surgical outcomes and associated complications for patients with right-sided vs. left-sided substernal goitres. OBJECTIVE: This study evaluated the characteristics and clinical outcomes of patients who underwent surgical management of substernal goitres, presenting factors indicating the use of a thoracic approach and differences between right- and left-sided goitre extensions...
March 2016: International Journal of Surgery
Krishnan Ravikumar, Dhalapathy Sadacharan, Sankaran Muthukumar, Gajrajan Mohanpriya, Zahir Hussain, R V Suresh
BACKGROUND: The external branch of the superior laryngeal nerve (EBSLN) is at surgical risk during superior thyroid pole ligation during thyroidectomy. Majority of studies have addressed the identification of these nerves and its reported incidence. Very few studies have addressed the relationship of these nerves with the volume of the thyroid gland and presence of toxicity. MATERIALS AND METHODS: A retrospective evaluation of 456 patients who underwent total thyroidectomy were analysed from the prospectively maintained database...
March 2016: World Journal of Surgery
Yoshihiko Kumai, Narihiro Kodama, Daizo Murakami, Eiji Yumoto
The objective of this study was to compare time-dependent improvements in phonatory function and stroboscopic findings following two different procedures for immediate reconstruction of the recurrent laryngeal nerve (RLN) during neck tumor extirpation. Seventeen patients with neck tumors, consisting of advanced thyroid cancer (n = 15), metastatic neck lymph nodes from other malignant lesions (n = 2), underwent resection of the primary lesion and involved RLN. Immediate RLN reconstruction by either: (1) ansa cervicalis nerve (ACN) to RLN anastomosis (n = 8); or (2) placement of the great auricular nerve (GAN) between the cut ends of the RLN (n = 9) was performed from 2000 to 2011...
April 2016: European Archives of Oto-rhino-laryngology
Su-Jin Kim, Kyu Eun Lee, Byung-Mo Oh, Eun Mee Oh, Dong Sik Bae, June Young Choi, Jun Pyo Myong, Yeo-Kyu Youn
PURPOSE: The aim of this study was to evaluate the feasibility of monitoring external branch of the superior laryngeal nerve (EBSLN) during robotic thyroid surgery. METHODS: A total of 10 patients undergoing bilateral axillo-breast approach (BABA) robotic thyroid surgery were enrolled. The nerve integrity monitor (NIM Response 2.0 System) was used for EBSLN monitoring. We performed voice assessments preoperatively and at 1 and 3 months postoperatively using Voice Handicap Index-10 (VHI-10), maximal phonation time (MPT), phonation efficient index (PEI), and laryngeal electromyography (EMG)...
November 2015: Annals of Surgical Treatment and Research
Luis-Mauricio Hurtado-López, Pastor Israel Díaz-Hernández, Erich Basurto-Kuba, Felipe Rafael Zaldívar-Ramírez, Abraham Pulido-Cejudo
BACKGROUND: This study investigated whether visual localization of the external branch of the superior laryngeal nerve (EBSLN) coincides with its localization via intraoperative neuro-monitoring (IONM) during thyroidectomy and whether its use influences the frequency of injuries. METHODS: A prospective, comparative, cross-sectional, observational study was performed in 240 superior thyroid poles. The metrics were visual identification of the EBSLN and its corroboration with IONM...
January 2016: Thyroid: Official Journal of the American Thyroid Association
Xiaoxia Wang, Xiaobao Yao, Honghui Li, Yanxia Bai, Shaoqiang Zhang, Zhen Shen
OBJECTIVE: To discuss the safe approach to exposure of the recurrent laryngeal nerve (RLN) in thyroid second operation. METHOD: The data of 153 patients with thyroid second operation were analyzed retrospectively to compare the effectiveness of superior and inferior approach in the exposure of RLN. RESULT: A total of 177 RLNs were exposed in 153 cases. Among those 39 RLNs were exposed by superior approach, 34 by inferior approach after failure of superior approach, and 104 by inferior approach...
June 2015: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Basel Al Kadah, Micaela Piccoli, Barbara Mullineris, Giovanni Colli, Martin Janssen, Stephan Siemer, Bernhard Schick
Endoscopic surgery for treatment of thyroid and parathyroid pathologies is increasingly gaining attention. The da Vinci system has already been widely used in different fields of medicine and quite recently in thyroid and parathyroid surgery. Herein, we report about modifications of the transaxillary approach in endoscopic surgery of thyroid and parathyroid gland pathologies using the da Vinci system. 16 patients suffering from struma nodosa in 14 cases and parathyroid adenomas in two cases were treated using the da Vinci system at the ENT Department of Homburg/Saar University and in cooperation with the Department of General Surgery in New Sant'Agostino Hospital, Modena/Italy...
March 2015: Journal of Robotic Surgery
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