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Recurrent laryngeal nerve

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https://www.readbyqxmd.com/read/28208891/outcomes-of-capsular-dissection-technique-with-use-of-bipolar-electrocautery-in-total-thyroidectomy-a-rural-tertiary-center-experience
#1
Amal T Das, S B Prakash, V Priyadarshini
INTRODUCTION: Total thyroidectomy is one of the most routinely performed head and neck surgical procedures with extremely low mortality. This procedure has been associated with two major complications such as recurrent laryngeal nerve injury and hypocalcaemia due to parathyroid insufficiency. The use of bipolar electrocautery has not been widely accepted in view of thermal damage to adjacent structures. AIM: To study the outcomes and complications of capsular dissection technique along with use of bipolar electrocautery in total thyroidectomy...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28207903/correction-reversing-age-related-changes-of-the-laryngeal-muscles-by-chronic-electrostimulation-of-the-recurrent-laryngeal-nerve
#2
Michael Karbiener, Jonathan C Jarvis, Justin D Perkins, Hermann Lanmüller, Martin Schmoll, Hanna S Rode, Claus Gerstenberger, Markus Gugatschka
[This corrects the article DOI: 10.1371/journal.pone.0167367.].
2017: PloS One
https://www.readbyqxmd.com/read/28203464/unilateral-laryngeal-pacing-system-and-its-functional-evaluation
#3
Taiping Zeng, Zhiping Zhang, Weiwei Peng, Fei Zhang, Baker Y Shi, Fangyi Chen
Goal. To establish a reliable instrumental system for synchronized reactivation of a unilaterally paralyzed vocal fold and evaluate its functional feasibility. Methods. Unilateral vocal fold paralysis model was induced by destruction of the left recurrent laryngeal nerve (RLN) in anesthetized dogs. With a micro controller-based electronic system, electromyography (EMG) signals from cricothyroid (CT) muscle on the ipsilateral side were recorded and used to trigger pacing of paralyzed vocalis muscles. The dynamic movement of vocal folds was continuously monitored using an endoscope, and the opening and closing of the glottis were quantified with customized imaging processing software...
2017: Neural Plasticity
https://www.readbyqxmd.com/read/28196399/relationship-of-the-recurrent-laryngeal-nerve-to-the-inferior-thyroid-artery-a-comparison-of-findings-from-two-systematic-reviews
#4
REVIEW
Anthony P Polednak
Systematic reviews (SRs) of anatomical studies may include a meta-analysis (MA) that provides weighted averages as pooled estimates of prevalence. The relationship of the recurrent laryngeal nerve (RLN) to the inferior thyroid artery (ITA) or its branches has been assessed in two published SRs, one without MA of 32 studies (SR1) and the other with MA of 79 studies (SR2). Both SRs reported differences in RLN-ITA patterns (in three categories) by side of the body, but the anterior pattern was less frequent in SR1 vs...
February 14, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28196195/association-of-otolaryngology-resident-duty-hour-restrictions-with-procedure-specific-outcomes-in-head-and-neck-endocrine-surgery
#5
Aaron Smith, Lauren Braden, Jim Wan, Merry Sebelik
Importance: Graduate medical education has undergone a transformation from traditional long work hours to a restricted plan to allow adequate rest for residents. The initial goal of this restriction is to improve patient outcomes. Objective: To determine whether duty hour restrictions had any impact on surgery-specific outcomes by analyzing complications following thyroid and parathyroid procedures performed before and after duty hour reform. Design, Setting, and Participants: Retrospective cross-sectional analysis of the National Inpatient Sample (NIS)...
February 9, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28195018/glottic-closing-force-versus-laryngeal-adductory-pressure-in-the-canine-larynx
#6
Randal C Paniello, Neel K Bhatt
INTRODUCTION: The strength of glottic closure with recurrent laryngeal nerve (RLN) stimulation has been indirectly measured experimentally by determining the squeezing pressure on a balloon inserted between the vocal folds, termed laryngeal adductory pressure (LAP). In this study, we sought to measure glottic closing force (GCF) directly and compare these results to LAP measures obtained with identical stimulation parameters. METHODS: In canines, a method for measuring GCF was developed in which a suture was looped through a lateral thyrotomy hole, around the vocal process and back, then attached to a force gauge...
March 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28194664/phrenic-nerve-stimulation-during-neck-dissection-for-advanced-thyroid-cancer-involving-level-iv-is-it-worth-doing-it
#7
Carlos S Duque, Juan P Dueñas, Marcela Marulanda, Diana Pérez, Andres Londoňo, Soham Roy, Mai Al Khadem
During thyroidectomy and neck dissection surgery for advanced or recurrent metastatic thyroid cancer under intraoperative monitoring, we used the available technology to assess the feasibility of such an intervention to monitor those patients with phrenic nerves at risk. A retrospective review of patients operated on from January 2009 to December 2015 by a single surgeon (CSD) was conducted. Patients who had neck and mediastinal dissection, with or without total thyroidectomy, due to advanced or recurrent metastatic disease to the neck were selected...
February 13, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28185774/is-the-superior-laryngeal-nerve-really-safe-when-using-harmonic-focus-in-total-thyroidectomy-a-prospective-randomized-study
#8
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/28178132/a-new-method-of-subtotal-thyroidectomy-for-graves-disease-leaving-a-unilateral-remnant-based-on-the-upper-pole
#9
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/28169093/subjective-and-objective-voice-assessments-after-recurrent-laryngeal-nerve-preserved-total-thyroidectomy
#10
Chariton E Papadakis, Panagiota Asimakopoulou, Efklidis Proimos, George Perogamvrakis, Effrosyni Papoutsaki, Theognosia Chimona
OBJECTIVES: This study aims to investigate early voice changes after total thyroidectomy, to assess the improved parameters in intermediate postoperative intervals, to evaluate the effect of age on voice after thyroidectomy, and to determine the correlation between the objective and the subjective method outcomes. STUDY DESIGN: This is a prospective, nonrandomized study. MATERIALS AND METHODS: One hundred ninety-one participants, divided into two age groups, underwent three full voice assessments (preoperatively and 1 and 8 weeks after thyroidectomy) by means of videostroboscopy, perceptual evaluation, acoustic analysis, aerodynamic evaluation, and a self-evaluation questionnaire...
February 3, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/28165567/surgical-safety-analysis-of-retaining-the-glands-in-papillary-thyroid-microcarcinoma
#11
B Ding, J-F Yu, W Sun, N-F Ma
OBJECTIVE: The objective of the present study was to analyze the surgical safety of retaining the glands in papillary thyroid microcarcinoma (mPTC). PATIENTS AND METHODS: 156 cases of mPTC were retrospectively reviewed and divided into four groups according to the treatment: group A (conservative follow-up group, 30 cases), group B (total resection of unilateral gland combined with isthmic resection, 48 cases), group C (total resection of unilateral gland combined with subtotal resection of contralateral gland, 47 cases), and group D (total resection of bilateral glands, 31 cases)...
January 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28149807/continuous-intraoperative-neural-monitoring-of-the-recurrent-nerves-in-thyroid-surgery-a-quantum-leap-in-technology
#12
REVIEW
Rick Schneider, Gregory W Randolph, Marcin Barczynski, Gianlorenzo Dionigi, Che-Wei Wu, Feng-Yu Chiang, Andreas Machens, Dipti Kamani, Henning Dralle
The continuous intraoperative neural monitoring (CIONM) technique is increasingly acknowledged as a useful tool to recognize impending nerve injury and to abort the related manoeuvre to prevent nerve injury during thyroid surgery. CIONM provides valuable real-time information constantly, which is really useful during complex thyroid surgeries especially in the settings of unusual anatomy. Thus, CIONM overcomes the key methodological limitation inherent in intermittent nerve monitoring (IINOM); which is allowing the nerve to be at risk in between the stimulations...
December 2016: Gland Surgery
https://www.readbyqxmd.com/read/28149804/neck-ultrasonography-for-detection-of-non-recurrent-laryngeal-nerve
#13
Marilisa Citton, Giovanni Viel, Maurizio Iacobone
BACKGROUND: Non-recurrent laryngeal nerve (NRLN) is a rare anatomical variant (0.3-6%) that is associated with some arterial abnormalities (absence of the brachiocephalic trunk and presence of a right aberrant subclavian lusorian artery). The availability of a preoperative diagnosis of NRLN may reduce the risk of nerve injuries. Preoperative ultrasonography (US) has been suggested as a reliable diagnostic tool to detect the arterial abnormalities associated with NRLN, but the literature is relatively scarce...
December 2016: Gland Surgery
https://www.readbyqxmd.com/read/28149802/operative-bed-recurrence-of-thyroid-cancer-utility-of-a-preoperative-needle-localization-technique
#14
Oliver S Eng, Scott B Grant, Jason Weissler, Mitchell Simon, Sudipta Roychowdhury, Tomer Davidov, Stanley Z Trooskin
BACKGROUND: Surgical management of recurrent disease after total thyroidectomy and/or neck dissection for thyroid carcinoma remains a challenging clinical problem. Reoperation is associated with a significant increase in morbidity. Preoperative needle localization technique for non-palpable breast tumors has recently been extrapolated to head and neck surgery. We report on the use of preoperative ultrasound-guided needle localization for non-palpable recurrent operative bed disease as an intraoperative aid in resection...
December 2016: Gland Surgery
https://www.readbyqxmd.com/read/28149798/transoral-endoscopic-thyroidectomy-vestibular-approach-toetva-for-graves-disease-a-comparison-of-surgical-results-with-open-thyroidectomy
#15
Pornpeera Jitpratoom, Khwannara Ketwong, Thanyawat Sasanakietkul, Angkoon Anuwong
BACKGROUND: Transoral endoscopic thyroidectomy vestibular approach (TOETVA) provides excellent cosmetic results from its potential for scar-free operation. The procedure has been applied successfully for Graves' disease by the authors of this work and compared with the standard open cervical approach to evaluate its safety and outcomes. METHODS: From January 2014 to November 2016, a total of 97 patients with Graves' disease were reviewed retrospectively. Open thyroidectomy (OT) and TOETVA were performed in 49 patients and 46 patients, respectively...
December 2016: Gland Surgery
https://www.readbyqxmd.com/read/28149542/does-videomediastinoscopy-with-frozen-sections-improve-mediastinal-staging-during-video-assisted-thoracic-surgery-pulmonary-resections
#16
Alessandro Gonfiotti, Stefano Bongiolatti, Domenico Viggiano, Sara Borgianni, Roberto Borrelli, Giorgia Tancredi, Massimo O Jaus, Leonardo Politi, Camilla E Comin, Luca Voltolini
BACKGROUND: To assess if video-mediastinoscopy (VM) with frozen sections (FS) combined with a video-assisted thoracic surgery major pulmonary resection (VMPRS) is able to improve VATS mediastinal intraoperative staging. METHODS: From June 2012 to March 2015 a total of 146 patients underwent VMPRS lymphadenectomy. NCCN guidelines were followed for pre-operative staging, including VM with FS in 27 patients (19%). Procedural time, dissected nodal stations, complications related to VM and VATS lymphadenectomy and definitive histology, were evaluated...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28147340/proposed-modifications-of-supraclavicular-lymph-node-metastasis-in-the-esophageal-squamous-cell-carcinoma-staging-system-for-improved-survival-stratification
#17
Yuzhen Zheng, Zhen Wang, Feng Wang, Qingyuan Huang, Shuoyan Liu
The present study aims to investigate the clinical implication of supraclavicular lymph nodes (SCLNs) in thoracic esophageal squamous cell carcinoma (ESCC). A total of 1156 ESCC patients who underwent three-field lymphadenectomy with node metastasis were analyzed retrospectively. SCLNs were defined as regional nodes in the current system or as distant nodes in the modified system. Survival was analyzed using the Kaplan-Meier method, and values were compared using the log-rank test. Multivariate analysis was performed using the Cox proportional hazard model...
January 29, 2017: Oncotarget
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
#18
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/28142325/continuous-intraoperative-neuromonitoring-study-using-pigs-for-the-prevention-of-mechanical-recurrent-laryngeal-nerve-injury-in-esophageal-surgery
#19
Tomoaki Deguchi, Yoshifumi Ikeda, Masanori Niimi, Ryoji Fukushima, Masaki Kitajima
PURPOSES: During esophageal surgery, clamping injury and injury associated with the use of energy devices are common mechanisms underlying intraoperative recurrent laryngeal nerve (RLN) damage. Recently, intraoperative neuromonitoring (IONM) has been applied to prevent RLN injury. This study was aimed at investigating the changes in the EMG signals associated with clamping injury of the RLN caused by picking up of the nerve with tweezers in domestic pigs. METHODS: Six domestic pigs (12 RLNs) underwent continuous IONM (CIONM) by our original automated periodic vagal nerve stimulation method...
January 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28139363/surgical-management-of-primary-thyroid-tumours
#20
P Asimakopoulos, I J Nixon
The majority of patients who present with well differentiated thyroid cancer will require surgery, but decisions on the appropriate primary procedure will depend on information relating to patient, tumour and surgical factors. As the incidence of thyroid cancer continues to rise, it is critical that clinicians involved in the management of these cases understand the factors which underpin surgical decision making for individual patients. Reporting outcomes in well differentiated thyroid cancer (WDTC) has always been challenging due to the low recurrence and mortality rate of the disease...
January 19, 2017: European Journal of Surgical Oncology
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