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Recurrent laryngeal nerve

Xiao-Feng Duan, Peng Tang, Xiao-Bin Shang, Hong-Jing Jiang, Zhen-Tao Yu
OBJECTIVE: To evaluate the prevalence, pattern and risk factors of lymph node metastasis (LNM) for pathological T1 (pT1) esophageal cancer (EC). METHODS: The clinical data of 143 cases of pT1 patients who underwent esophagectomy and lymph node dissection during January 2011 and July 2016 were reviewed, including 120 male patients and 23 female patients with a median age of 60 years. The pattern of LNM was analyzed and the risk factors related to LNM were assessed by logistic regression analysis...
March 2018: Surgical Oncology
H-Y Deng, W-X Huang, G Li, S-X Li, J Luo, G Alai, Y Wang, L-X Liu, Y-D Lin
Whether the robot-assisted minimally invasive esophagectomy (RAMIE) has any advantages over the video-assisted minimally invasive esophagectomy (VAMIE) remains controversial. In this study, we tried to compare the short-term outcomes of RAMIE with that of VAMIE in treating middle thoracic esophageal cancer from a single medical center. Consecutive patients undergoing RAMIE or VAMIE for middle thoracic esophageal cancer from April 2016 to April 2017 were prospectively included for analysis. Baseline data and pathological findings as well as short-term outcomes of these two group (RAMIE group and VAMIE group) patients were collected and compared...
March 9, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Xiao-Chun Mao, Chao Chen, Ke-Jing Wang
PURPOSE: To compare the efficacy and safety profiles of LigaSure™ small jaw instrument (LSJI) versus conventional technique in patients undergoing open thyroidectomy. METHODS: This single-center, prospective, observational study conducted in Zhejiang Provincial Cancer Hospital enrolled patients who underwent thyroidectomy between September 2013 and September 2014. The primary study outcomes included determination of blood loss, operative duration, length of hospital stay, and drainage volume...
March 13, 2018: European Archives of Oto-rhino-laryngology
Xiaoli Liu, Daqi Zhang, Guang Zhang, Lina Zhao, Le Zhou, Yantao Fu, Shijie Li, Yishen Zhao, Changlin Li, Che-Wei Wu, Feng-Yu Chiang, Gianlorenzo Dionigi, Hui Sun
AIM: We assess the prevalence and mechanism of recurrent laryngeal nerve (RLN) injury in central neck dissection (CND) for thyroid cancer. METHODS: CND with intraoperative neural monitoring was outlined in 1.273 nerves at risk (NAR). RLN lesions were stratified according to: timing (during thyroidectomy versus CND), segmental vs. diffuse injury, mechanism, severity, location, number of lymph nodes dissected and metastastatic. EMG parameters were recorded. RESULTS: 49/1...
January 31, 2018: Surgical Oncology
Seong Yong Park, Jee Won Suh, Dae Joon Kim, Jun Chul Park, Eun Hye Kim, Chang Young Lee, Jin Gu Lee, Hyo Chae Paik, Kyoung Young Chung
BACKGROUND: It is still unclear that dissection of recurrent laryngeal nerve nodes is mandatory in patients with cT1 middle or lower thoracic esophageal squamous cell carcinoma when the nodes are negative in preoperative staging work-up. We aimed to evaluate the feasibility of near-infrared image-guided lymphatic mapping of bilateral recurrent laryngeal nerve nodes. METHODS: The day before surgery, we injected indocyanine green (ICG) into submucosal layer by endoscopy...
March 5, 2018: Annals of Thoracic Surgery
Hanyue Li, Yingjie Hu, Jia Huang, Yunhai Yang, Kaichen Xing, Qingquan Luo
BACKGROUND: Vagus nerve and recurrent laryngeal nerve (RLN) injury are not rare complications of lung cancer surgery and can cause lethal consequences. Until now, no optimal method other than paying greater attention during surgery has been available. METHODS: Four patients underwent lung surgery that involved RLN or vagus nerve injury. The left RLN or vagus nerve was cut off and then reconstructed immediately during surgery. Two patients underwent direct anastomosis, while the remaining two underwent phrenic nerve replacing tension-relieving anastomosis...
March 2, 2018: Thoracic Cancer
T Gramann, C Schwab, V Zumstein, P Betschart, M Meier, H-P Schmid, D S Engeler
PURPOSE: To establish whether bipolar transurethral resection of tumours (bTURB) on the lateral bladder wall is superior to monopolar transurethral resection (mTURB) of such tumours. To our knowledge, this is the first prospective randomised study, which defines complete resection depending on obturator jerk as primary endpoint. METHODS: In a prospective, randomised, single centre study, 52 patients with newly diagnosed or recurrent bladder tumour on the lateral bladder wall were enrolled and randomised to undergo mTURB or bTURB; 44 patients were eligible for analysis, of whom 21 underwent mTURB and 23 bTURB...
March 1, 2018: World Journal of Urology
Blake S Raggio, Blair M Barton, Emad Kandil, Paul L Friedlander
Importance: No evidence exists to direct the management of preoperative aspirin (acetylsalicylic acid) use in patients undergoing thyroid surgery. Nevertheless, a considerable number of patients interrupt receiving aspirin therapy during the preoperative period to minimize bleeding complications despite the increased risk of experiencing major adverse cardiac events. Objective: To determine whether aspirin therapy continued preoperatively increases bleeding complications in patients undergoing thyroid surgery...
March 1, 2018: JAMA Otolaryngology—Head & Neck Surgery
Hongyi Liu, Yu Pu, Yaping Xu, He Xu, Huanhai Liu, Yin Cheng, Weihua Xu, Xiaoping Chen, Jingping Fan
The aim of this study was to investigate whether the transplantation of olfactory-ensheathing cells (OECs) could physiologically repair severely injured recurrent laryngeal nerve (RLN) in dogs. Adult Beagle dogs were surgically introduced with a 10-mm defect in the left RLN and transplanted with a nerve guide (NEUROLAC) containing dog olfactory mucosa-olfactory-ensheathing cells (OM-OECs) in matrigel. The effects of OM-OECs on the morphology, histology, and electrophysiology of the injured RLNs, glottis movement, and voice acoustics were comparatively studied...
February 28, 2018: Molecular and Cellular Biochemistry
Masami Yuda, Katsunori Nishikawa, Keita Takahashi, Takanori Kurogochi, Yujiro Tanaka, Akira Matsumoto, Yuichiro Tanishima, Norio Mitsumori, Katsuhiko Yanaga
BACKGROUND: There have been only sporadic reports on intraoperative nerve monitoring (IONM) during esophageal cancer surgery. We aimed to establish a strategy for the use of IONM during esophagectomy. PATIENTS AND METHODS: Forty-one cases enrolled in this study. The IONM was performed before and after lymph node dissection in the thoracic cavity and cervical area. Occurrence of recurrent laryngeal nerve (RLN) palsy was assessed on the seventh postoperative day. RESULTS: The identification of nerves using IONM was possible in all cases...
March 2018: Anticancer Research
Lawrence Chen, Yi-Hsiu Wu, Chia-Hwa Lee, Hsin-An Chen, El-Wui Loh, Ka-Wai Tam
BACKGROUND: Central neck dissection and total thyroidectomy are standard treatments for patients with papillary thyroid carcinoma (PTC) with clinically involved central nodes. However, prophylactic central neck dissection (pCND) in patients with clinically uninvolved cN0 has been beneficial in some studies but ineffective in others. We conducted a meta-analysis to evaluate the efficacy and safety of pCND in patients with central neck lymph nodes cN0 PTC. METHODS: The PubMed, EMBASE, Cochrane Library, and Scopus databases and the ClinicalTrials...
February 27, 2018: World Journal of Surgery
Emad Kandil, Khuzema Mohsin, Mohammad A Murcy, Gregory W Randolph
OBJECTIVES/HYPOTHESIS: Continuous intraoperative neuromonitoring (CIONM) of the vagus nerve was proposed to obtained frequent repetitive electromyography (EMG) data to recognize early change in intraoperative function of the recurrent laryngeal nerve. We examine our initial experience using this technology. STUDY DESIGN: Retrospective review. METHODS: Data for all patients who underwent neck surgery by a single surgeon at a North American institution over a 5-year period were reviewed...
February 26, 2018: Laryngoscope
Baihua Zhang, Junliang Ma, Xinjian Yan, Xu Li, Qin Xiao, Wenxiang Wang, Yong Zhou
RATIONALE: Minimally invasive esophagectomy (MIE) have been increasingly used and are regarded as suitable alternatives to open esophagectomy. However, few previous reports described minimally invasive esophagectomy using a left-sided approach. PATIENT CONCERNS AND DIAGNOSES: A 71-year-old man was admitted to our hospital because of progressive dysphagia. Synchronous double primary thoracic esophageal and left lung cancers were considered before the operation. INTERVENTIONS AND OUTCOMES: A lobectomy and MIE, via a left video-assisted thoracoscopic approach, was performed...
January 2018: Medicine (Baltimore)
Ashley Ballester, François Gould, Laura Bond, Bethany Stricklen, Jocelyn Ohlemacher, Andrew Gross, Katherine DeLozier, Randall Buddington, Karyl Buddington, Nicole Danos, Rebecca German
The timing of the occurrence of a swallow in a respiratory cycle is critical for safe swallowing, and changes with infant development. Infants with damage to the recurrent laryngeal nerve, which receives sensory information from the larynx and supplies the intrinsic muscles of the larynx, experience a significant incidence of dysphagia. Using our validated infant pig model, we determined the interaction between this nerve damage and the coordination between respiration and swallowing during postnatal development...
February 24, 2018: Dysphagia
Ismail Cem Sormaz, Fatih Tunca, Yasemin Giles Şenyürek
PURPOSE: To evaluate the bilateral patterns and motor function of the extralaryngeal branches (ELB) of the recurrent laryngeal nerve(RLN). METHODS: This study included 500 consecutive patients who underwent total thyroidectomy. Intraoperative nerve monitoring (IONM) was used in 230 patients. Demographic data, indications for surgery, the bilateral patterns of ELB of the RLN, electromyographic activity of the ELB, distance between the branching point to the entrance into the larynx, and the rate of postoperative morbidity were analyzed...
February 21, 2018: Surgical and Radiologic Anatomy: SRA
Paul Muhle, Sonja Suntrup-Krueger, Rainer Dziewas, Tobias Warnecke
Varicella zoster virus reactivation is a rare cause of pharyngeal dysphagia with long-term sequelae persisting in most cases. A 76-year-old immunocompetent woman presented with a 4-week history of dysphagia and dysphonia. Brain magnetic resonance imaging displayed a negative finding. Fiberoptic endoscopic evaluation of swallowing showed a severe dysphagia leading to a percutaneous gastrostomy eventually. Cerebrospinal fluid analysis revealed a lymphocytic pleocytosis and polymerase chain reaction amplified Varicella zoster virus DNA...
2018: SAGE Open Medical Case Reports
Christopher E Fundakowski, Nathan W Hales, Nishant Agarwal, Marcin Barczyński, Pauline M Camacho, Dana M Hartl, Emad Kandil, Whitney E Liddy, Travis J McKenzie, John C Morris, John A Ridge, Rick Schneider, Jonathan Serpell, Catherine F Sinclair, Samuel K Snyder, David J Terris, R Michael Tuttle, Che-Wei Wu, Richard J Wong, Mark Zafereo, Gregory W Randolph
"I have noticed in operations of this kind, which I have seen performed by others upon the living, and in a number of excisions, which I have myself performed on the dead body, that most of the difficulty in the separation of the tumor has occurred in the region of these ligaments…. This difficulty, I believe, to be a very frequent source of that accident, which so commonly occurs in removal of goiter, I mean division of the recurrent laryngeal nerve." Sir James Berry (1887).
February 20, 2018: Head & Neck
SeungWon Lee, KiNam Park
OBJECTIVES: This study compared and assessed long-term voice outcomes when thyroidectomy-related unilateral vocal fold paralysis (VFP) was managed using injection laryngoplasty (IL) and recurrent laryngeal nerve reinnervation (RLNR). STUDY DESIGN: Prospective clinical study. METHODS: A prospective clinical trial was performed from March 2005 to January 2016 at Soonchunhyang University Bucheon Hospital (Bucheon, South Korea). Nineteen patients who underwent ansa cervicalis to RLNR or direct reinnervation, and 43 patients who underwent IL to treat thyroidectomy-related unilateral VFP, were enrolled...
February 16, 2018: Laryngoscope
Suresh Mohan, Sarah N Bowe, Lara M Hirner, Claire Zar-Kessler, Christopher J Hartnick
Pediatric cricopharyngeal achalasia is an uncommon but important cause of oropharyngeal dysphagia. Failure of upper esophageal sphincter relaxation is the currently understood pathophysiology. Therapies include balloon dilation, botulinum toxin injection, and endoscopic or open cricopharyngeal myotomy (CPM). Open CPM is usually performed at the posterior midline of the cricopharyngeus and can be a risky procedure given concern for esophageal perforation and damage to the recurrent laryngeal nerve. Here, we present a novel modified technique for open CPM using a superficial anterolateral transection approach in the case of a young male with refractory cricopharyngeal achalasia...
February 2018: International Journal of Pediatric Otorhinolaryngology
Gianlorenzo Dionigi, Che-Wei Wu, Ralph P Tufano, Antonio Giacomo Rizzo, Angkoon Anuwong, Hui Sun, Paolo Carcoforo, Cancellieri Antonino, Mattia Portinari, Hoon Yub Kim
This video aimed to describe the role of intraoperative neuromonitoring (IONM) during transoral endoscopic thyroidectomy vestibular approach (TOETVA) with emphasis given to IONM technical and technological notes, the identification of recurrent laryngeal nerve (RLN). Standardized technique of IONM consist in identifying and monitoring both the vagus nerve and the RLNs before and after resection (V1, V2, R1, R2). According to this report, IONM during TOETVA is feasible and safe in providing identification and function of laryngeal nerves...
2018: Journal of Visualized Surgery
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