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Recurrent laryngeal nerve

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https://www.readbyqxmd.com/read/28528064/transient-aphonia-after-mediastinoscopy
#1
Frank O Velez-Cubian, Kavian Toosi, Jessica Glover, Bharat Pancholy, Edward Hong
The most common adverse event after cervical mediastinoscopy is recurrent laryngeal nerve (RLN) injury, which has an incidence of 0.6% [1]. We report the case of a 68-year-old man with non-small cell lung cancer (NSCLC) who experienced transient bilateral vocal cord paralysis after mediastinoscopy, which manifested in complete aphonia. This patient's ability to maintain his airway was carefully followed up, but neither endotracheal intubation nor tracheostomy was required. The vocal cord paralysis resolved without intervention after 5 hours...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28528013/congenital-h-type-tracheoesophageal-fistula-a-multicenter-review-of-outcomes-in-a-rare-disease
#2
Sara C Fallon, Jacob C Langer, Shawn D St Peter, KuoJen Tsao, Caroline M Kellagher, Dave R Lal, Jill S Whitehouse, Diana L Diesen, Michael D Rollins, Elizabeth Pontarelli, Marcus M Malek, Corey W Iqbal, Jeffrey S Upperman, Charles M Leys, Mark L Wulkan, Sarah J Hill, Martin L Blakely, Timothy D Kane, David E Wesson
OBJECTIVE: To perform a multicenter review of outcomes in patients with H-type tracheoesophageal fistula (TEF) in order to better understand the incidence and causes of post-operative complications. BACKGROUND: H-type TEF without esophageal atresia (EA) is a rare anomaly with a fundamentally different management algorithm than the more common types of EA/TEF. Outcomes after surgical treatment of H-type TEF are largely unknown, but many authoritative textbooks describe a high incidence of respiratory complications...
May 11, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28527715/influence-of-netrin-1-on-reinnervation-of-laryngeal-muscles-following-recurrent-laryngeal-nerve-injury
#3
Ignacio Hernandez-Morato, Shira Koss, Sansar Sharma, Michael J Pitman
Following recurrent laryngeal nerve (RLN) injury, recovery results in poor functional restitution of the paralyzed vocal fold. Netrin-1 has been found to be upregulated in the rat posterior cricoarytenoid muscle (PCA) during nerve regeneration, We evaluated the effect of ectopic Netrin-1 in the PCA during RLN reinnervation. The right RLN was transected and Netrin-1 was injected into the PCA (2.5, 5, 10, 15, 20μg/ml). At 7 days post injury fluorescent retrograde tracer was injected into PCA and Thyroarytenoid (TA) muscles...
May 17, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28523362/transoral-endoscopic-thyroidectomy-our-initial-experience-using-a-new-endoscopic-technique
#4
Jun-Ook Park, Dong-Il Sun
BACKGROUND: A transoral approach has been experimentally introduced to the field of thyroid surgery and several groups in Asia have recently used the technique to treat patients. We performed transoral endoscopic thyroidectomies on patients with thyroid cancer or a benign tumor. METHODS: We reviewed the medical records of patients who underwent transoral endoscopic thyroid surgery between July 2016 and January 2017. A midline incision was made in the vestibule, and a 10 mm cannula was placed; then, the working space was widened by insufflating CO2 at a pressure of 5-6 mmHg...
May 18, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28523132/uniportal-transcervical-video-assisted-thoracoscopic-surgery-vats-approach-for-pulmonary-lobectomy-combined-with-transcervical-extended-mediastinal-lymphadenectomy-temla
#5
Marcin Zieliński, Mariusz Rybak, Katarzyna Solarczyk-Bombik, Michal Wilkojc, Wojciech Czajkowski, Sylweriusz Kosinski, Edward Fryzlewicz, Tomasz Nabialek, Juliusz Pankowski
BACKGROUND: To present the technique of uniportal transcervical video-assisted thoracoscopic surgery (VATS) approach for pulmonary lobectomy combined with transcervical extended mediastinal lymphadenectomy (TEMLA). METHODS: Transcervical extended approach utilizes a typical a 5-8 centimeters collar incision in the neck. The critical technical point enabling a wide access to the chest is an elevation of the sternal manubrium with a special retractor (modified Rochard frame, Asculap-Chifa Company)...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28523127/high-intensity-focused-ultrasound-hifu-ablation-of-benign-thyroid-nodules-a-systematic-review
#6
REVIEW
Brian Hung-Hin Lang, Arnold L H Wu
BACKGROUND: With an increasing number of imaging studies being done nowadays, the number of incidentally discovered thyroid nodules is expected to rise. Although many of these nodules are small and benign in nature, some do grow and may cause pressure and/or thyrotoxic symptoms. Surgical resection has traditionally been recommended for symptomatic nodules but is associated with risk of hypothyroidism, bleeding, infection, and nerve damage. High intensity focused ultrasound (HIFU) is one of the non-surgical thermal ablation techniques that may serve as an alternative in the treatment of benign thyroid nodules...
2017: Journal of Therapeutic Ultrasound
https://www.readbyqxmd.com/read/28522763/aortic-arch-compliance-and-idiopathic-unilateral-vocal-fold-paralysis
#7
Reza Behkam, Kara E Roberts, Andrew J Bierhals, M Eileen Jacobs, Julia D Edgar, Randal C Paniello, Gayle Woodson, Jonathan P Vande Geest, Julie M Barkmeier-Kraemer
Unilateral vocal fold paralysis (UVP) occurs related to recurrent laryngeal nerve (RLN) impairment associated with impaired swallowing, voice production, and breathing functions. The majority of UVP cases occur subsequent to surgical intervention with approximately 12-42% having no known cause for the disease (i.e., idiopathic). Approximately 2/3 of those with UVP exhibit left-sided injury with the average onset at 50 years of age or older in those diagnosed as idiopathic. Given the association between the RLN and the subclavian and aortic arch vessels, we hypothesized that changes in vascular tissues would result in increased aortic compliance in idiopathic left-sided UVP patients compared to those without UVP...
May 18, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28510799/practical-surgical-techniques-for-lymphadenectomy-along-the-right-recurrent-laryngeal-nerve-during-thoracoscopic-esophagectomy-in-the-prone-position
#8
Taro Oshikiri, Tetsu Nakamura, Yukiko Miura, Hiroshi Hasegawa, Masashi Yamamoto, Shingo Kanaji, Kimihiro Yamashita, Yoshiko Matsuda, Takeru Matsuda, Yasuo Sumi, Satoshi Suzuki, Yoshihiro Kakeji
BACKGROUND: In esophageal squamous cell cancer (SCC), lymphadenectomy along the right recurrent laryngeal nerve (RLN) is important for disease control. The metastatic rate was 33% and the 5-year overall survival rate of these patients was 33.3%,1 but the risk of RLN palsy increases.2 We reported a reliable new method ('Pincers Maneuver')3 for lymphadenectomy along the right RLN during thoracoscopic esophagectomy in the prone position (TEP), and hereby present our video, aimed at providing a complete and safe dissection...
May 16, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28508841/morbidity-of-central-compartment-clearance-comparison-of-lesser-versus-complete-clearance-in-patients-with-thyroid-cancer
#9
Gouri Pantvaidya, Rakesh Katna, Anuja Deshmukh, Deepa Nair, Anil D'Cruz
BACKGROUND: Extent of central compartment neck dissection (CCND) in thyroid cancers has been a debate because of associated morbidity. There have been attempts to reduce the extent of surgery in an attempt to decrease morbidity. PATIENTS AND METHODS: We analyzed the morbidity of CCND from our prospectively maintained surgical morbidity database. CCND was divided into bilateral complete clearance (BCC) and less than complete clearance (LCC). LCC was performed for clinicoradiologically node negative patients...
January 2017: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28506418/timing-and-extension-of-lymphadenectomy-in-medullary-thyroid-carcinoma-a-case-series-from-a-single-institution
#10
Andrea Polistena, Alessandro Sanguinetti, Roberta Lucchini, Sergio Galasse, Massimo Monacelli, Stefano Avenia, Andrea Boccolini, Louis Banka Johnson, Nicola Avenia
BACKGROUND: Medullary thyroid carcinoma is an aggressive tumor and presents with significant morbidity and mortality and a high rate of lymph node metastases. The combination of total thyroidectomy and cervical lymphadenectomy is the essential treatment for those patients presenting with cervical lymph node metastases. MATERIALS AND METHODS: A retrospective analysis of 117 patients operated for medullary thyroid carcinoma over a period of 15 years at a single institution...
May 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28506414/unintentional-recurrent-laryngeal-nerve-injuries-following-thyroidectomy-is-it-the-surgeon-who-pays-the-bill
#11
REVIEW
C Gambardella, A Polistena, A Sanguinetti, R Patrone, S Napolitano, D Esposito, D Testa, V Marotta, A Faggiano, P G Calò, N Avenia, G Conzo
BACKGROUND: Thyroidectomy is one of the most common intervention in general surgery and, after the turn of the century, its rate has sharply increased, along with a worldwide increased incidence of differentiated thyroid cancers. Therefore, injuries of the recurrent laryngeal nerve have become one of the most frequent cause of surgical malpractice claims, mostly following surgery for benign pathology. MAIN BODY: Even if the incidence of definitive paralysis is generally lower than 3%, during the last 20 years in Italy, the number of claims for damages has sharply raised...
May 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28506412/rationality-in-prophylactic-central-neck-dissection-in-clinically-node-negative-cn0-papillary-thyroid-carcinoma-is-there-anything-more-to-say-a-decade-experience-in-a-single-center
#12
C Dobrinja, M Troian, T Cipolat Mis, G Rebez, S Bernardi, B Fabris, L Piscopello, P Makovac, F Di Gregorio, N de Manzini
AIM: Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy. Despite its extremely favorable prognosis, cervical lymph node metastases are a common feature of PTC and a known independent risk factor for local recurrence. However, the role of prophylactic central neck dissection (PCND) remains a matter of debate in patients with clinically node-negative (cN0) PTC. To better clarify the current role of PCND in the surgical treatment of PTC, evaluating advantages and disadvantages of PCND and outcome of cN0 PTC patients who have been treated with either total thyroidectomy alone or in combination with PCND...
May 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28501106/concurrent-endocrine-and-other-surgical-procedures-an-institutional-experience
#13
Rachel Morris, Tina W F Yen, Kara Doffek, Azadeh A Carr, Stuart D Wilson, Douglas B Evans, Tracy S Wang
INRODUCTION: The number of endocrine procedures, specifically parathyroidectomy, thyroidectomy, and adrenalectomy, being performed is increasing. There is a paucity of literature on the feasibility of combining these procedures with other surgical procedures. Therefore, the aim of this study was to determine the effect of performing concurrent surgical procedures on postoperative outcomes. METHODS: This is a single institution retrospective review of multiple prospectively maintained databases of patients who underwent elective thyroidectomy, parathyroidectomy, and/or adrenalectomy in combination with another procedure...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28493593/superior-parathyroid-gland-approach-to-the-recurrent-laryngeal-nerve
#14
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...
May 11, 2017: Head & Neck
https://www.readbyqxmd.com/read/28493220/continuous-intraoperative-neural-monitoring-in-thyroid-surgery-a-mexican-experience
#15
Karla Verónica Chávez, Jackeline Ramírez, Juan Pablo Pantoja, Mauricio Sierra, David Velázquez-Fernández, Miguel F Herrera
Intraoperative continuous neural monitoring (C-IONM) during thyroid surgery has been recognized as a useful tool to identify and confirm recurrent laryngeal nerve integrity. The aim of the present study is to analyze electromyographic features and thresholds for normal vocal fold function in our initial experience with C-IONM in thyroid surgery. C-IONM was utilized in 57 patients who underwent thyroid surgery between July 2012 and December 2015. EMG parameters were analyzed looking for potential predictors of postoperative vocal fold dismotility...
May 10, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28492904/screening-for-thyroid-cancer-updated-evidence-report-and-systematic-review-for-the-us-preventive-services-task-force
#16
Jennifer S Lin, Erin J Aiello Bowles, Selvi B Williams, Caitlin C Morrison
Importance: The incidence of detected thyroid cancer cases has been increasing in the United States since 1975. The majority of thyroid cancers are differentiated cancers with excellent prognosis and long-term survival. Objective: To systematically review the benefits and harms associated with thyroid cancer screening and treatment of early thyroid cancer in asymptomatic adults to inform the US Preventive Services Task Force. Data Sources: Searches of MEDLINE, PubMed, and the Cochrane Central Register of Controlled Trials for relevant studies published from January 1966 through January 2016, with active surveillance through December 2016...
May 9, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28486741/-implementation-of-a-vessel-sealing-device-in-a-centre-for-thyroid-surgery-risk-and-economic-profit
#17
Stephan Coerper, Wolfgang Stengl
Background This study investigated whether the use of the vessel sealing device LigaSure Small Jaw(™) is cost-effective and safe in thyroid surgery despite the high cost of material. Patients and Methods We analysed the results of 224 thyroid operations performed by the same surgeon in three time intervals. We included thyroidectomies and bilateral near-total resections (including Dunhill surgery). Minimally-invasive resections (MIVAT), unilateral resections or subtotal resections (remains > 2 ml), patients with recurrent goiter, operations with neck dissections and sternotomies were excluded...
May 9, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28473292/risk-factors-and-the-preoperative-assessment-of-right-para-oesophageal-lymph-node-metastasis-in-right-lobe-papillary-thyroid-carcinoma-a-case-series
#18
You Qu, Hao Zhang, Ping Zhang, Wenwu Dong, Liang He, Wei Sun, Jinhao Liu
BACKGROUND: Right para-oesophageal lymph nodes (RPELN) are included among the right central compartment lymph nodes (rCLN) and located behind right recurrent laryngeal nerve (rRLN). However, due to the likelihood of increasing postoperative complications, and the extremely difficulties of RPELN dissection, the decision to perform RPELN dissection remains controversial. The aim of this study was to explore the risk factors of RPELN metastasis and evaluate RPELN metastasis by preoperative examination...
May 1, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28467621/intraoperative-nerve-monitoring-during-parathyroid-surgery-the-fort-worth-experience
#19
Moustafa Mourad, Sameep Kadakia, Ameya Jategaonkar, Eli Gordin, Yadranko Ducic
BACKGROUND: Avoidance of recurrent laryngeal nerve (RLN) injury during parathyroid surgery is of paramount important. The purpose of this study was to determine if intraoperative nerve monitoring allowed for decreased rates of RLN injury during parathyroid surgery. METHOD: Between 1997 and 2016, 213 patients undergoing parathyroidectomy were retrospectively analyzed to determine postoperative recurrent nerve injury. Eighty-seven patients did not have intraoperative nerve monitoring, whereas 126 patients did...
May 3, 2017: Head & Neck
https://www.readbyqxmd.com/read/28458598/innovative-techniques-for-image-guided-ablation-of-benign-thyroid-nodules-combined-ethanol-and-radiofrequency-ablation
#20
REVIEW
Hye Sun Park, Jung Hwan Baek, Young Jun Choi, Jeong Hyun Lee
In the treatment of benign thyroid nodules, ethanol ablation (EA), and radiofrequency ablation (RFA) have been suggested for cystic and solid thyroid nodules, respectively. Although combining these ablation techniques may be effective, no guidelines for or reviews of the combination have been published. Currently, there are three ways of combining EA and RFA: additional RFA is effective for treatment of incompletely resolved symptoms and solid residual portions of a thyroid nodule after EA. Additional EA can be performed for the residual unablated solid portion of a nodule after RFA if it is adjacent to critical structures (e...
May 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
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