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https://www.readbyqxmd.com/read/28917827/recommendations-on-the-use-of-neuromonitoring-in-thyroid-and-parathyroid-surgery
#1
José Luis Pardal-Refoyo, Pablo Parente-Arias, Marta María Arroyo-Domingo, Juan Manuel Maza-Solano, José Granell-Navarro, Jesús María Martínez-Salazar, Ramón Moreno-Luna, Elvylins Vargas-Yglesias
INTRODUCTION: Thyroid and parathyroid surgery (TPTS) is associated with risk of injury to the recurrent laryngeal nerve, superior laryngeal nerve and voice changes. Intraoperative neuromonitoring (IONM), intermittent or continuous, evaluates the functional state of the laryngeal nerves and is being increasingly used. This means that points of consensus on the most controversial aspects are necessary. OBJECTIVE: To develop a support document for guidance on the use of IONM in TPTS...
September 14, 2017: Acta Otorrinolaringológica Española
https://www.readbyqxmd.com/read/28776686/contralateral-r1-and-r2-components-of-the-laryngeal-adductor-reflex-in-humans-under-general-anesthesia
#2
Catherine F Sinclair, Maria J Téllez, Oscar R Tapia, Sedat Ulkatan
OBJECTIVES: To demonstrate that under total intravenous general anesthesia (TIVA), the contralateral R1 (cRI) and contralateral R2 (cR2) components of the laryngeal adductor reflex (LAR) can be reliably elicited; to determine effects of topical anesthesia and inhalational anesthesia on the LAR; and to discuss how this technique may be utilized to continuously monitor the vagus nerve reflex arc. STUDY DESIGN: Case series. METHODS: Vocal fold mucosa was electrically stimulated via endotracheal tube surface-based electrodes to elicit a LAR...
August 4, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28759458/pharyngolaryngeal-symptoms-associated-with-thyroid-disease
#3
Inn-Chul Nam, Young-Hak Park
PURPOSE OF REVIEW: The current review summarizes previous reports on laryngopharyngeal symptoms associated with thyroid disease. This review also includes pharyngolaryngeal symptoms caused by thyroidectomy. However, we focus on pharyngolaryngeal symptoms following uncomplicated thyroidectomy, as this is an important issue in the fields of otolaryngology. RECENT FINDINGS: An enlarged thyroid gland, as in thyroiditis, multinodular goiter, or large nodules, can cause compressive symptoms...
July 28, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28713236/modulation-of-calcitonin-parathyroid-hormone-and-thyroid-hormone-secretion-by-electrical-stimulation-of-sympathetic-and-parasympathetic-nerves-in-anesthetized-rats
#4
Harumi Hotta, Akiko Onda, Harue Suzuki, Philip Milliken, Arun Sridhar
The thyroid and parathyroid glands are dually innervated by sympathetic (cervical sympathetic trunk [CST]) and parasympathetic (superior laryngeal nerve [SLN]) nerve fibers. We examined the effects of electrical stimulation of efferent or afferent nerve fibers innervating the thyroid and parathyroid glands on the secretion of immunoreactive calcitonin (iCT), parathyroid hormone (iPTH), 3,3',5-triiodothyronine (iT3), and thyroxine (iT4) from the thyroid and parathyroid glands. In anesthetized and artificially ventilated rats, thyroid venous blood was collected...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28687919/superior-laryngeal-nerve-in-thyroid-surgery-anatomical-identification-and-monitoring
#5
M Gavid, M D Dubois, E Larivé, J M Prades
The aim of this study was to validate a procedure to identify and preserve the external branch of the superior laryngeal nerve (EBSLN) during thyroid surgery. The present study also aimed to analyze the EBSLN and the vagus nerve activities after stimulation and demonstrate an operative association between all the laryngeal muscles. Dissection of the cervical region was performed bilaterally in four adult cadavers. In a second step, 144 patients undergoing total thyroidectomy were included. Intraoperative stimulations of the cervical vagus nerve and the EBSLN in the sternothyroid-laryngeal triangle were performed bilaterally...
July 7, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28679839/vibration-over-the-larynx-increases-swallowing-and-cortical-activation-for-swallowing
#6
Rachel W Mulheren, Christy L Ludlow
Sensory input can alter swallowing control in both the cortex and brainstem. Electrical stimulation of superior laryngeal nerve afferents increases reflexive swallowing in animals, with different frequencies optimally effective across species. Here we determined 1) if neck vibration overlying the larynx affected the fundamental frequency of the voice demonstrating penetration of vibration into the laryngeal tissues, and 2) if vibration, in comparison with sham, increased spontaneous swallowing and enhanced cortical hemodynamic responses to swallows in the swallowing network...
September 1, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28624166/retrograde-thyroidectomy-for-preservation-of-the-external-branch-of-the-superior-laryngeal-nerve-a-case-series
#7
Vijay Naraynsingh, Shamir Cawich, Dale Hassranah, Ravi Maharaj, Shariful Islam, Yardesh Singh
BACKGROUND: The external branch of the Superior Laryngeal nerve (EBSLN) is at high risk of injury in surgery for large multinodular goitre (MNG) since the upper pole is high in the neck, well cephalad to the EBSLN. We present a technique of drawing the lobe caudally by retrograde thyroidectomy in order to minimize nerve injury. DESIGN & METHOD: All patients having surgery for benign MNG were included. Cases with previous thyroid surgery, malignant and toxic disease were excluded...
May 15, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28577534/a-novel-variation-of-the-recurrent-laryngeal-nerve
#8
Gaosong Wu, Kun Wang
BACKGROUND: Injury to the recurrent laryngeal nerve is one of the most severe complications of thyroid surgery. Several anatomic variations of the nerve increase the likelihood of iatrogenic damage. CASE PRESENTATION: A 50-year-old woman was presented to our department with a nodule in the right thyroid lobe, and she reported no voice changes. She had no history of surgery or radiation to the head or neck. Fine-needle aspiration was recorded as papillary thyroid carcinoma...
June 2, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28493593/superior-parathyroid-gland-approach-to-the-recurrent-laryngeal-nerve
#9
Ezzeddin Elsheikh
BACKGROUND: The superior parathyroid gland is known to be almost constant in its location under the false thyroid capsule. Could it be a landmark to point to the site of incision of the false thyroid capsule and find the plane of the recurrent laryngeal nerve (RLN) during thyroidectomy? METHODS: The study included 48 patients with benign goiter scheduled for hemithyroidectomy or total thyroidectomy; there were 16 cases of solitary thyroid nodules, 27 cases of multinodular goiter, and 5 cases of toxic goiter...
July 2017: Head & Neck
https://www.readbyqxmd.com/read/28466363/the-identification-preservation-and-classification-of-the-external-branch-of-the-superior-laryngeal-nerve-in-thyroidectomy
#10
Kun Wang, Huilan Cai, Deguang Kong, Qiuxia Cui, Dan Zhang, Gaosong Wu
BACKGROUND: Avoiding injury to the external branch of the superior laryngeal nerve is one of the major challenges during thyroid operation. The aim of this study was to propose a practical classification of the external branch of the superior laryngeal nerve. METHODS: A retrospective study of total thyroidectomy was performed. Totally 240 patients were included, with 480 external branches of the superior laryngeal nerves explored by intraoperative neuromonitoring...
May 2, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28439772/neuromonitoring-in-endoscopic-and-robotic-thyroidectomy
#11
REVIEW
Gianlorenzo Dionigi, Hoon Yub Kim, Che-Wei Wu, Matteo Lavazza, Gabriele Materazzi, Celestino Pio Lombardi, Angkoon Anuwong, Ralph P Tufano
Intraoperative neuromonitoring (IONM) has proven effective for intraoperative verification of RLN function in the conventional thyroid surgery. However, no studies have performed a systematic evidence-based assessment of this novel health technology in endoscopic and robotic thyroidectomy. Evidence-based criteria were used in a systematic review of relevant literature for years 2000-2015. Four electronic databases (CENTRAL, MEDLINE, Cochrane and EMBASE) were used to retrieve relevant reports published from January 1, 2000 to September 1, 2016...
April 24, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28247855/the-evaluation-of-the-complications-observed-in-patients-with-bilateral-total-and-bilateral-near-total-thyroidectomy
#12
Tolga Dinc, Selami Ilgaz Kayilioglu, Besir Simsek, Cem Emir Guldogan, Mehmet Onur Gulseren, Baris Saylam, Faruk Coskun
AIM: The objective was to compare the recurrent laryngeal nerve (RLN) and superior laryngeal nerve (SLN) injuries in patients with bilateral total thyroidectomy (BTT) and bilateral near total thyroidectomy (BNTT) with the frequency of the hypocalcemic complications regarding the operation procedures. MATERIALS AND METHODS: Patients, who underwent BTT and BNTT in our clinic between January 1999 and January 2011, were included in this retrospective clinical study...
February 24, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28238161/effect-of-energy-based-devices-on-voice-quality-after-total-thyroidectomy
#13
RANDOMIZED CONTROLLED TRIAL
Server Sezgin Uludag, Serkan Teksoz, Akif Enes Arikan, Ozge Tarhan, Haydar Murat Yener, Murat Ozcan, Whitney Liddy, Gregory William Randolph
Voice alteration is an important complication of thyroid surgery and is closely related to patients' quality of life. There are no studies analyzing effect of energy-based devices (EBD) on voice quality (VQ). Aim of this prospective study is to evaluate impact of sutureless total thyroidectomy performed with EBDs on objective voice parameters of patients without recurrent laryngeal nerve (RLN) and/or external branch of superior laryngeal nerve (EBSLN) injury. Sixty patients underwent total thyroidectomy with meticulous dissection of EBSLN...
May 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28185774/is-the-superior-laryngeal-nerve-really-safe-when-using-harmonic-focus-in-total-thyroidectomy-a-prospective-randomized-study
#14
Kemal Arslan, Bulent Erenoglu, Osman Dogru, Gultekin Ovet, Ersin Turan, Arif Atay, Hande Koksal
BACKGROUND: Harmonic focus (HF) was introduced in thyroid surgery in an effort to reduce operation time and complications. OBJECTIVE: The present study aimed to compare function of superior laryngeal nerve and incidence of other postoperative complications in total thyroidectomies using HF and conventional ligation (CL). METHODS: The trial is a randomized single-center, single-blinded study. Patients aged ≥ 18 years scheduled for total thyroidectomy were considered for participation...
February 6, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28182829/transoral-endoscopic-thyroidectomy-vestibular-approach-toetva-from-a-to-z
#15
Gianlorenzo Dionigi, Matteo Lavazza, Alessandro Bacuzzi, Davide Inversini, Vincenzo Pappalardo, Ralph P Tufano, Hoon Yub Kim, Angkoon Anuwong
We depict the transoral endoscopic thyroidectomy vestibular approach (TOETVA). Patient selection criteria are (1) ultrasonographically (US) estimated thyroid diameter no larger than 10cm, (2) US estimated gland volume ≥45mL, (3) nodule size ≥5mm, (4) a benign tumor, such as a thyroid cyst, single-nodular goiter, or multinodular goiter, (5) follicular neoplasm, and (6) papillary microcarcinoma without evidence of metastasis. TOETVA is carried out through a three-port technique placed at the oral vestibule, one 10mm port for 30° endoscope and two additional 5mm ports for dissecting and coagulating instruments...
February 7, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28178132/a-new-method-of-subtotal-thyroidectomy-for-graves-disease-leaving-a-unilateral-remnant-based-on-the-upper-pole
#16
RANDOMIZED CONTROLLED TRIAL
Yu Liu, Bin Liu, Rui-Lei Liu, Hua Jiang, Ze-Nan Huang, Yong Huang
BACKGROUND: The aim of this prospective randomized study was to evaluate the feasibility of subtotal thyroidectomy with leaving a unilateral remnant based on the upper pole. METHODS: Patients who underwent the subtotal thyroidectomy and isthmusectomy leaving either a unilateral remnant based on the upper pole (Group I, 79 patients) or the bilateral dorsal thyroid tissue remained (Group II, 89 patients) were compared in operation time, blood loss, recurrence, and postoperative complications...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28144954/monitoring-of-the-posterior-cricoarytenoid-muscle-represents-another-option-for-neural-monitoring-during-thyroid-surgery-normative-vagal-and-recurrent-laryngeal-nerve-posterior-cricoarytenoid-muscle-electromyographic-data
#17
Whitney Liddy, Samuel R Barber, Brian M Lin, Dipti Kamani, Natalia Kyriazidis, Bradley Lawson, Gregory W Randolph
OBJECTIVE: Intraoperative neural monitoring (IONM) of laryngeal nerves using electromyography (EMG) is routinely performed using endotracheal tube surface electrodes adjacent to the vocalis muscles. Other laryngeal muscles such as the posterior cricoarytenoid muscle (PCA) are indirectly monitored. The PCA may be directly and reliably monitored through an electrode placed in the postcricoid region. Herein, we describe the method and normative data for IONM using PCA EMG. STUDY DESIGN: Retrospective review...
January 31, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28132134/laryngeal-electromyographic-changes-in-postthyroidectomy-patients-with-normal-vocal-cord-mobility
#18
Kemal Keseroglu, Omer Bayir, Ebru Karaca Umay, Guleser Saylam, Emel Cadalli Tatar, Ali Ozdek, Mehmet Hakan Korkmaz
Thyroidectomy has been used for the treatment of thyroid disease for more than 100 years. In spite of the advancement of surgical techniques, there is still a risk of laryngeal nerve injury. The risk of partial or complete injury still depends on some surgical and disease-related factors. The aim of this study is to show the partial injury and to establish these risk factors via laryngeal electromyographic analysis (LEMG) in postthyroidectomy patients with normal vocal cord motion and mucosal anatomy. Patients who had undergone thyroid surgery were enrolled in this prospective study...
April 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28049375/comparative-effectiveness-of-treatment-choices-for-graves-hyperthyroidism-a-historical-cohort-study
#19
Vishnu Sundaresh, Juan P Brito, Prabin Thapa, Rebecca S Bahn, Marius N Stan
BACKGROUND: The optimum therapy for Graves' disease (GD) is chosen following discussion between physician and patient regarding benefits, drawbacks, potential side effects, and logistics of the various treatment options, and it takes into account patient values and preferences. This cohort study aimed to provide useful information for this discussion regarding the usage, efficacy, and adverse-effect profile of radioactive iodine (RAI), antithyroid drugs (ATDs), and thyroidectomy in a tertiary healthcare facility...
April 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28035477/contribution-of-intraoperative-neural-monitoring-to-preservation-of-the-external-branch-of-the-superior-laryngeal-nerve-a-randomized-prospective-clinical-trial
#20
Mehmet Uludag, Nurcihan Aygun, Kinyas Kartal, Bulent Citgez, Evren Besler, Gurkan Yetkin, Cemal Kaya, Hamdi Ozsahin, Mehmet Mihmanli, Adnan Isgor
PURPOSE: The purpose of this study was to evaluate the effect of intraoperative neuromonitoring (IONM) on the injury rate of the external branch of the superior laryngeal nerve (EBSLN) during thyroidectomy. METHODS: A total of 133 consenting patients (98 female, 35 male; mean age, 45.6 ± 11.7 years) undergoing thyroidectomy were randomly assigned to 2 groups. In group 1 (n = 65 patients, 105 nerves), superior thyroid pole dissection was performed with no attempt to identify the EBSLN; in group 2 (n = 68 patients, 106 nerves), IONM was used to identify the EBSLN during surgery...
December 29, 2016: Langenbeck's Archives of Surgery
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