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Recurrent laryngeal nerve

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https://www.readbyqxmd.com/read/29142846/opportunities-and-challenges-of-intermittent-and-continuous-intraoperative-neural-monitoring-in-thyroid-surgery
#1
REVIEW
Rick Schneider, Andreas Machens, Gregory W Randolph, Dipti Kamani, Kerstin Lorenz, Henning Dralle
The number of thyroid operations and there radically continues to rise in the western hemisphere, bringing prevention of recurrent laryngeal nerve (RLN) palsy to the fore. Overall, the incidence of RLN palsy is fairly low but continues to prompt litigation for malpractice. In an effort to diminish transient, and more importantly permanent, RLN palsy rates, intraoperative neuromonitoring (IONM) has been advocated as a risk minimization tool. Recent meta-analyses of studies, many of which were limited by poor study design and the sole use of intermittent nerve stimulation, were unable to demonstrate superiority of IONM over mere anatomic RLN dissection...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142841/speech-therapy-after-thyroidectomy
#2
REVIEW
Wing-Hei Viola Yu, Che-Wei Wu
Common complaints of patients who have received thyroidectomy include dysphonia (voice dysfunction) and dysphagia (difficulty swallowing). One cause of these surgical outcomes is recurrent laryngeal nerve paralysis. Many studies have discussed the effectiveness of speech therapy (e.g., voice therapy and dysphagia therapy) for improving dysphonia and dysphagia, but not specifically in patients who have received thyroidectomy. Therefore, the aim of this paper was to discuss issues regarding speech therapy such as voice therapy and dysphagia for patients after thyroidectomy...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142834/two-stage-thyroidectomy-in-the-era-of-intraoperative-neuromonitoring
#3
Christos Christoforides, Ioannis Papandrikos, Georgios Polyzois, Nikolaos Roukounakis, Gianlorenzo Dionigi, Kyriakos Vamvakidis
Background: The use of intraoperative neuromonitoring (IONM) provides surgeons with real time information about recurrent laryngeal nerves (RLN) functional integrity. Hence, allowing them to modify the initially scheduled bilateral procedure, to a two-stage thyroidectomy in cases of loss of signal (LOS) on the first side of resection resulting in minimization of bilateral RLN injury. The purpose of our study was to present our results since the implementation of the above mentioned process in both malignant and benign thyroid disease...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29137052/arytenoid-cartilage-dislocation-mimicking-bilateral-vocal-cord-paralysis-a-case-report
#4
Eun H Chun, Hee J Baik, Rack K Chung, Hun J Lee, Kwangseob Shin, Jae H Woo
RATIONALE: Arytenoid dislocation is very rare and may be misdiagnosed as vocal cord paralysis or a self-limiting sore throat. PATIENT CONCERNS: A 70-year-old male (70 kg, 156 cm) was scheduled for transurethral resection of bladder tumors. A McGrath videolaryngoscope, with a basic cuffed Mallinckrodt oral tracheal tube of 7.5 mm internal diameter, was used to successfully intubate his trachea. The duration of surgery was 25 minutes. In the recovery room, he complained of sore throat and dyspnea with inspiratory stridor, which were not resolved after intravenous injection of 10 mg of dexamethasone...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136734/-functional-recovery-after-recurrent-laryngeal-nerve-injury-on-different-electromyography-thresholds-during-thyroid-surgery
#5
X L Liu, C L Li, Y S Zhao, H Sun
Objective: To discuss the functional recovery after recurrent laryngeal nerve injury (RLNI) on different electromyography thresholds during thyroid surgery. Methods: The prospective experimentally were induced in 12 acute recurrent laryngeal traction animals (porcine) from December 2014 to December 2015, the amplitude and latency of electromyography, even time course during RLNI and recovery of 24 recurrent laryngeal nerves(RLN) were continuous intraoperative neuromonitoring(IONM), including 12 RLN releasing traction after 50% amplitude decrease (AD) and other 12 RLN after 70% AD...
November 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29128183/does-intraoperative-neuromonitoring-of-recurrent-nerves-have-an-impact-on-the-postoperative-palsy-rate-results-of-a-prospective-multicenter-study
#6
Éric Mirallié, Cécile Caillard, François Pattou, Laurent Brunaud, Antoine Hamy, Marcel Dahan, Michel Prades, Muriel Mathonnet, Gérard Landecy, Henri-Pierre Dernis, Jean-Christophe Lifante, Frederic Sebag, Franck Jegoux, Emmanuel Babin, Alain Bizon, Florent Espitalier, Isabelle Durand-Zaleski, Christelle Volteau, Claire Blanchard
BACKGROUND: The impact of intraoperative neuromonitoring on recurrent laryngeal nerve palsy remains debated. Our aim was to evaluate the potential protective effect of intraoperative neuromonitoring on recurrent laryngeal nerve during total thyroidectomy. METHODS: This was a prospective, multicenter French national study. The use of intraoperative neuromonitoring was left at the surgeons' choice. Postoperative laryngoscopy was performed systematically at day 1 to 2 after operation and at 6 months in case of postoperative recurrent laryngeal nerve palsy...
November 8, 2017: Surgery
https://www.readbyqxmd.com/read/29124354/parathyroid-thyroid-and-recurrent-laryngeal-nerve-anatomy-in-an-indian-rhinoceros-rhinoceros-unicornis
#7
R Udelsman, S B Citino, M Prasad, P I Donovan, D V Fredholm
INTRODUCTION: The parathyroid gland was first identified in the Indian rhinoceros in 1849 by Sir Richard Owen. We performed a necropsy in an Indian rhinoceros, recapitulating Owen's dissection and display what appear to be the initial identification of the recurrent laryngeal nerve in situ and the anatomy and histology of the largest rhinoceros parathyroid glands yet identified. MATERIALS AND METHODS: Patrick T. Rhino, a 41-year-old Indian rhinoceros was born in 1974...
November 9, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29124033/intraoperative-recurrent-laryngeal-nerve-monitoring-in-a-patient-with-contralateral-vocal-fold-palsy
#8
Bub-Se Na, Jin-Ho Choi, In Kyu Park, Young Tae Kim, Chang Hyun Kang
Recurrent laryngeal nerve injury can develop following cervical or thoracic surgery; however, few reports have described intraoperative recurrent laryngeal nerve monitoring. Consensus regarding the use of this technique during thoracic surgery is lacking. We used intraoperative recurrent laryngeal nerve monitoring in a patient with contralateral vocal cord paralysis who was scheduled for completion pneumonectomy. This case serves as an example of intraoperative recurrent laryngeal nerve monitoring during thoracic surgery and supports this indication for its use...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29120517/outpatient-versus-inpatient-thyroidectomy-a-systematic-review-and-meta-analysis
#9
REVIEW
Daniel J Lee, Christopher J Chin, Chris J Hong, Stefan Perera, Ian J Witterick
BACKGROUND: Outpatient thyroidectomy has gained popularity due to improved resource utilization. METHODS: We conducted a systematic review and meta-analysis using MEDLINE, EMBASE, CINAHL, Web of Science, and the Cochrane library. We included all studies examining the outcomes of outpatient thyroidectomy as compared with those of inpatient thyroidectomy. Risk of bias was assessed using the Newcastle-Ottawa scale. Postoperative complications (hematoma, hypocalcemia, and recurrent laryngeal nerve injury) and readmission/reintervention rates were compared...
November 9, 2017: Head & Neck
https://www.readbyqxmd.com/read/29119329/a-functional-assessment-of-anatomical-variants-of-the-recurrent-laryngeal-nerve-during-thyroidectomies-using-neuromonitoring
#10
Beata Wojtczak, Krzysztof Kaliszewski, Krzysztof Sutkowski, Marek Bolanowski, Marcin Barczyński
PURPOSE: The aim of the study was to assess the usefulness of intraoperative neuromonitoring (IONM) in identifying anatomical variants of the recurrent laryngeal nerve (RLN) during thyroidectomies, with emphasis on the nerve's relationship to the inferior thyroid artery (ITA), Zuckerkandl's tubercle, nonrecurrent laryngeal nerves (NRLNs), and extralaryngeal bifurcation. METHODS: A total of 128 subjects undergoing surgery for thyroid disorders were enrolled in the study, and the course and anatomical variants of RLN were assessed with IONM application...
November 8, 2017: Endocrine
https://www.readbyqxmd.com/read/29119215/surgical-ligation-versus-percutaneous-closure-of-patent-ductus-arteriosus-in-very-low-weight-preterm-infants-which-are-the-real-benefits-of-the-percutaneous-approach
#11
A Rodríguez Ogando, I Planelles Asensio, A Rodríguez Sánchez de la Blanca, F Ballesteros Tejerizo, M Sánchez Luna, J M Gil Jaurena, C Medrano López, J L Zunzunegui Martínez
Percutaneous treatment of patent ductus arteriosus (PDA) in extreme premature infants is technically difficult, and therefore, often not consider as an alternative to surgery. The main objective of our work was to compare respiratory status prior and post ductal closure and morbi-mortality, in our series of preterm infants with percutaneous PDA closure versus surgical ligation in the same time-period. Retrospective review of all premature infants submitted to percutaneous and surgical PDA closure from January 2011 to December 2016...
November 8, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/29114900/standing-thyroidectomy-in-10-horses
#12
Marco Marcatili, Sarah J Voss, Patrick J Pollock
OBJECTIVE: To describe a surgical technique for thyroidectomy in horses with thyroid neoplasia under standing sedation and local anesthesia. STUDY DESIGN: Retrospective study. ANIMALS: Client-owned horses (n = 10). METHODS: Medical records of horses with a history of thyroid enlargement were included in the study if thyroid gland enlargement was treated surgically via hemi- or bilateral thyroidectomy, with the horse standing and sedated...
November 8, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29111336/regenerative-effects-of-basic-fibroblast-growth-factor-on-restoration-of-thyroarytenoid-muscle-atrophy-caused-by-recurrent-laryngeal-nerve-transection
#13
Mami Kaneko, Takuya Tsuji, Yo Kishimoto, Yoichiro Sugiyama, Tatsuo Nakamura, Shigeru Hirano
OBJECTIVES: Vocal fold atrophy following unilateral vocal fold paralysis is caused by atrophy of the thyroarytenoid (TA) muscle and remains a challenge. Medialization procedures are popular treatment options; however, hoarseness often remains due to the reduction in mass or tension of the TA muscle. Therefore, in addition to medialization procedures, TA muscle reinnervation is desirable. In vivo studies have shown the potential for basic fibroblast growth factor (bFGF) to affect muscular and nerve regeneration...
October 27, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/29110159/measuring-decision-making-during-thyroidectomy-validity-evidence-for-a-web-based-assessment-tool
#14
Amin Madani, Jordan Gornitsky, Yusuke Watanabe, Cassandre Benay, Maria S Altieri, Philip H Pucher, Roger Tabah, Elliot J Mitmaker
BACKGROUND: Errors in judgment during thyroidectomy can lead to recurrent laryngeal nerve injury and other complications. Despite the strong link between patient outcomes and intraoperative decision-making, methods to evaluate these complex skills are lacking. The purpose of this study was to develop objective metrics to evaluate advanced cognitive skills during thyroidectomy and to obtain validity evidence for them. METHODS: An interactive online learning platform was developed ( www...
November 6, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29110082/continuous-monitoring-of-the-recurrent-laryngeal-nerve
#15
Aitor De la Quintana Basarrate, Arantza Iglesias Martínez, Iciar Salutregui, Leire Agirre Etxabe, Ainhoa Arana González, Izaskun Yurrebaso Santamaría
OBJECTIVE: The objective of this study was to assess the safety and utility of continuous intraoperative neuromonitoring for the prevention of recurrent laryngeal nerve injury during thyroidectomy. METHODS: A prospective cohort study was conducted in consecutive patients undergoing thyroidectomy. Variations in amplitude and distal latency of the electromyogram (EMG) were assessed. In the case of suspicious events, restorative manoeuvers were performed to attempt to recover the potentials...
November 6, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29108371/clinical-value-and-indication-for-the-dissection-of-lymph-nodes-posterior-to-the-right-recurrent-laryngeal-nerve-in-papillary-thyroid-carcinoma
#16
Ding-Cun Luo, Xiao-Cheng Xu, Jin-Wang Ding, Yu Zhang, You Peng, Gang Pan, Wo Zhang
Lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN) are common sites of nodal recurrence after the resection of papillary thyroid carcinoma (PTC). However, the indication for LN-prRLN dissection remains debatable. We therefore studied the relationships between LN-prRLN metastasis and the clinicopathological characteristics in 306 patients with right or bilateral PTC who underwent LN-prRLN dissection. We found that LN-prRLN metastasis occurred in 16.67% of PTC and was associated with a number of the clinicopathological features...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29100907/feasibility-and-safety-of-nerve-stimulator-attachment-to-energy-based-devices-a-porcine-model-study
#17
Sung-Chan Shin, Eui-Suk Sung, Sung-Won Choi, Sung-Dong Kim, Da-Woon Jung, Seok-Hyun Kim, Jung Hoon Ro, Jin-Choon Lee, Byung-Joo Lee
BACKGROUND: Recently, several energy-based devices (EBDs) have been developed and applied in the context of thyroid surgery. EBDs can reduce operation time, blood loss, and postoperative pain. Compared to conventional electrocautery, EBDs operate at a relatively lower temperature and produce minimal lateral tissue damage. Yet, during device operation, the tip of the EBD is hot enough to cause thermal nerve damage, increasing the need for surgeons to be cautious about EBD application. To increase the safety of EBDs, we attached nerve stimulators to the tips of two EBDs and compared them to conventional monopolar nerve stimulation using a porcine model...
October 31, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29098272/adjuvant-external-beam-radiotherapy-in-locally-advanced-differentiated-thyroid-cancer
#18
Samantha Tam, Moran Amit, Mongkol Boonsripitayanon, Maria E Cabanillas, Naifa L Busaidy, G Brandon Gunn, Stephen Y Lai, Neil D Gross, Erich M Sturgis, Mark E Zafereo
Importance: As incidence of differentiated thyroid cancer rises, treatment paradigms have become increasingly defined. Despite this, locally advanced disease continues to be challenging to manage. Postoperative therapy in the form of radioactive iodine (RAI) is generally recommended, but the role of external beam radiation therapy (EBRT) is less well defined. Objective: To investigate the role of EBRT in locally advanced differentiated thyroid cancer. Design, Setting, and Participants: For this retrospective cohort study, patients treated surgically for T4a differentiated thyroid cancer at the University of Texas MD Anderson Cancer Center from January 2000 through December 2015 were recruited, and 88 patients were included for analysis...
November 2, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29095795/role-of-reinnervation-in-the-management-of-recurrent-laryngeal-nerve-injury-current-state-and-advances
#19
Virginia Fancello, S A Reza Nouraei, Kate J Heathcote
PURPOSE OF REVIEW: To present the current state of knowledge concerning different laryngeal reinnervation procedures for unilateral and bilateral vocal palsy. RECENT FINDINGS: Recent reports show positive outcomes on both unilateral and bilateral reinnervations. The phrenic nerve is the most commonly used donor for bilateral vocal palsy, but use of the superior laryngeal nerve has also been suggested. SUMMARY: Reinnervation of the larynx is a complex undertaking that can be performed by ENT surgeons with skills in microsurgery...
December 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/29092098/differentiated-and-anaplastic-thyroid-carcinoma-major-changes-in-the-american-joint-committee-on-cancer-eighth-edition-cancer-staging-manual
#20
REVIEW
Nancy D Perrier, James D Brierley, R Michael Tuttle
Answer questions and earn CME/CNE This is a review of the major changes in the American Joint Committee on Cancer staging manual, eighth edition, for differentiated and anaplastic thyroid carcinoma. All patients younger than 55 years have stage I disease unless they have distant metastases, in which case, their disease is stage II. In patients aged 55 years or older, the presence of distant metastases confers stage IVB, while cases without distant metastases are further categorized based on the presence/absence of gross extrathyroidal extension, tumor size, and lymph node status...
November 1, 2017: CA: a Cancer Journal for Clinicians
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