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Recurrent laryngeal nerve palsy

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https://www.readbyqxmd.com/read/28058549/reliable-surgical-techniques-for-lymphadenectomy-along-the-left-recurrent-laryngeal-nerve-during-thoracoscopic-esophagectomy-in-the-prone-position
#1
Taro Oshikiri, Tetsu Nakamura, Hiroshi Hasegawa, Masashi Yamamoto, Shingo Kanaji, Kimihiro Yamashita, Takeru Matsuda, Yasuo Sumi, Satoshi Suzuki, Yoshihiro Kakeji
BACKGROUND: Lymphadenectomy along the left recurrent laryngeal nerve (RLN) in esophageal cancer is important for disease control (1) but requires advanced dissection skills. We previously reported a reliable method (2) for lymphadenectomy along the left RLN during thoracoscopic esophagectomy in the prone position (TEP). The goal of this method is complete dissection of the lymph nodes along the left RLN in a safe manner. METHOD: This procedure is performed for all resectable thoracic esophageal cancers...
January 5, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28034775/systematic-review-and-meta-analysis-on-intra-operative-neuro-monitoring-in-high-risk-thyroidectomy
#2
REVIEW
Kai Pun Wong, Ka Lun Mak, Carlos King Ho Wong, Brian Hung Hin Lang
INTRODUCTION: Use of intra-operative neuro-monitoring (IONM) during high-risk thyroidectomy has been suggested to decrease the rate of recurrent laryngeal nerve (RLN) palsy. However, current evidences were mixed and there was no large-scale study concluding its benefit. We evaluated the role of IONM in reducing RLN palsy during high-risk thyroidectomy and identified which high-risk subgroup would be most benefited. METHODS: A systemic review was performed to identify studies comparing the use of IONM and visual identification of RLN alone (VA) during high-risk thyroidectomy, namely re-operation, thyroidectomy for malignancy, thyrotoxicosis or retrosternal goitre...
December 26, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/28034706/vagal-and-recurrent-laryngeal-nerves-neuromonitoring-during-thyroidectomy-and-parathyroidectomy-a-prospective-study
#3
N Julien, E Ferrary, A Sokoloff, G Lamas, O Sterkers, D Bernadeschi
OBJECTIVES: The aim of the study was to stimulate the vagal and the recurrent laryngeal nerves during and after thyroidectomy or parathyroidectomy, to record muscle responses, interpret the electrophysiological modifications and identify prognostic factors for postoperative vocal fold mobility. PATIENTS AND METHODS: A prospective study monitored 151 vagal nerves and 144 recurrent laryngeal nerves in 114 patients. Seven patients (14 vagal nerves) underwent continuous monitoring via an automatic periodic stimulation (APS(®)) electrode...
December 26, 2016: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/27989608/is-intraoperative-neural-monitoring-necessary-for-exploration-of-the-superior-laryngeal-nerve
#4
Mehmet Uludag, Nurcihan Aygun, Kinyas Kartal, Evren Besler, Adnan Isgor
BACKGROUND: We aimed to evaluate the contribution of intraoperative neuromonitoring to the visual and functional identification of the external branch of the superior laryngeal nerve and the effect on postoperative voice changes. METHODS: The prospective data of 221 patients (183 women, 38 men) who underwent thyroid operation with intraoperative neuromonitoring for exploration of the external branch of the superior laryngeal nerve were evaluated retrospectively...
December 15, 2016: Surgery
https://www.readbyqxmd.com/read/27941961/therapeutic-effects-of-bipolar-coagulation-forceps-on-open-thyroid-surgery
#5
Lei Su, Jiayong Li, Xiaoqiao Tang, Jianfeng Sang
BACKGROUND: The aim was to compare the therapeutic effects of bipolar coagulation forceps, harmonic scalpel, and conventional thyroidectomy on open thyroid surgery. METHODS: A total of 527 patients who received open thyroid surgery in the Affiliated Drum Tower Hospital of Nanjing University Medical School between February 2013 and February 2016 were randomly divided into three groups: bipolar coagulation forceps, harmonic scalpel, and conventional thyroidectomy...
September 2016: Revista de Investigación Clínica; Organo del Hospital de Enfermedades de la Nutrición
https://www.readbyqxmd.com/read/27932888/preoperative-risk-factors-in-total-thyroidectomy-of-substernal-goiter
#6
Aldo Bove, Raffaella Maria Di Renzo, Gauro D'Urbano, Manuela Bellobono, Vincenzo D' Addetta, Alfonso Lapergola, Giuseppe Bongarzoni
The definition of substernal goiter (SG) is based on variable criteria leading to a considerable variation in the reported incidence (from 0.2% to 45%). The peri- and postoperative complications are higher in total thyroidectomy (TT) for SG than that for cervical goiter. The aim of this study was to evaluate the preoperative risk factors associated with postoperative complications. From 2002 to 2014, 142 (8.5%; 98 women and 44 men) of the 1690 patients who underwent TT had a SG. We retrospectively evaluated the following parameters: sex, age, histology, pre- and retrovascular position, recurrence, and extension beyond the carina...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27927246/minimally-invasive-oesophagectomy-versus-open-esophagectomy-for-resectable-esophageal-cancer-a-meta-analysis
#7
REVIEW
Waresijiang Yibulayin, Sikandaer Abulizi, Hongbo Lv, Wei Sun
BACKGROUND: Open esophagectomy (OE) is associated with significant morbidity and mortality. Minimally invasive oesophagectomy (MIO) reduces complications in resectable esophageal cancer. The aim of this study is to explore the superiority of MIO in reducing complications and in-hospital mortality than OE. METHODS: MEDLINE, Embase, Science Citation Index, Wanfang, and Wiley Online Library were thoroughly searched. Odds ratio (OR)/weighted mean difference (WMD) with a 95% confidence interval (CI) was used to assess the strength of association...
December 8, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27867862/intermittent-neural-monitoring-of-the-recurrent-laryngeal-nerve-in-surgery-for-recurrent-goiter
#8
REVIEW
Beata Wojtczak, Marcin Barczyński
Reoperative thyroid surgery is still challenging even for skilled surgeons, and is associated with a higher incidence of complications, such as hypoparathyroidism and recurrent laryngeal nerve (RLN) palsy. Displacement of the RLN, scar tissue from previous neck surgery and difficulty in maintaining good hemostasis are risk factors in reoperations. The prevalence of RLN injury in reoperative thyroid surgery ranges as high as 12.5% for transient injury and up to 3.8% for permanent injury. Bilateral paresis can also occur during reoperations, and is a dangerous complication influencing the quality of life, sometimes requiring tracheostomy...
October 2016: Gland Surgery
https://www.readbyqxmd.com/read/27867546/transoral-endoscopic-mediastinal-surgery-toems-results-of-a-first-clinical-study-for-scarless-mediastinal-lymph-node-biopsies
#9
Wolfram Klemm, Steffen Frese, Gunda Leschber, André Nemat, Thomas Wilhelm
BACKGROUND: Video-assisted mediastinoscopy (VAM) represents the standard procedure for mediastinal lymph node biopsies. This operation results in a scar at prominent position at the anterior neck. Since there is a trend to less invasive procedures, natural orifice transluminal endoscopic surgery (NOTES) was introduced to different fields of surgery. Based on NOTES we developed a new approach for mediastinoscopy: transoral endoscopic mediastinal surgery (TOEMS). In previous studies using human cadavers and living pigs the feasibility of TOEMS was shown...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27866716/can-we-consider-immediate-complications-after-thyroidectomy-as-a-quality-metric%C3%A2-of-operation
#10
Jean-Christophe Lifante, Cécile Payet, Fabrice Ménégaux, Frédéric Sebag, Jean-Louis Kraimps, Jean-Louis Peix, François Pattou, Cyrille Colin, Antoine Duclos
BACKGROUND: Permanent recurrent laryngeal nerve palsy and hypoparathyroidism are 2 major complications after thyroid operation. Assuming that the rate of immediate complications can predict the permanent complication rate, some authors consider these complications as a valid metric for assessing the performance of individual surgeons. This study aimed to determine the correlation between rates of immediate and permanent complications after thyroidectomy at the surgeon level. METHODS: We conducted a prospective, cross-sectional study in 5 academic hospitals between April 2008 and December 2009...
January 2017: Surgery
https://www.readbyqxmd.com/read/27847133/c1-lateral-mass-screw-insertion-caudally-from-c2-nerve-root-an-alternate-method-for-insertion-of-c1-screws-a-technical-note-and-preliminary-clinical-results
#11
Keiji Wada, Ryo Tamaki, Mitsuru Yui, Daisuke Numaguchi, Yasuaki Murata
BACKGROUND: C1 lateral mass screw was widely used for fixation of the upper cervical spine. However, massive bleeding from the C1-2 venous plexus is sometimes encountered. In this study, we proposed an alternate method for C1 lateral mass screw insertion, which involves insertion of the screws caudally from the C2 nerve root to reduce bleeding from C1-2 venous plexus. METHODS: Seven patients with atlantoaxial lesions were included in this study. The mean age at surgery was 65...
November 12, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/27818960/vocal-fold-mobility-alteration-reversed-after-thyroidectomy
#12
Aline Paterno Miazaki, Vergilius José Furtado Araújo-Filho, Lenine Garcia Brandão, Vergilius José Furtado de Araujo-Neto, Leandro Luongo Matos, Claudio Roberto Cernea
The involvement of the inferior or recurrent laryngeal nerve (RLN) in mobility derangement of the vocal folds occurs more frequently due to thyroid malignancy invasion. Although uncommon, the same derangement, which is caused by benign thyroid entities, is also described and reverts to normality after a thyroidectomy in up to 89% of cases. In these cases, the pathogenesis of the vocal cord mobility disturbance is attributed to the direct compression of the RLN by massive thyroid enlargement. The authors describe three cases of patients presenting unilateral vocal cord palsy, which, before surgery, was diagnosed by laryngoscopy concomitantly with large and compressive goiter...
July 2016: Autopsy & case reports
https://www.readbyqxmd.com/read/27811857/phase-ii-study-of-chemoselection-with-docetaxel-plus-cisplatin-and-5-fluorouracil-induction-chemotherapy-and-subsequent-conversion-surgery-for-locally-advanced-unresectable-oesophageal-cancer
#13
Tomoya Yokota, Ken Kato, Yasuo Hamamoto, Yasuhiro Tsubosa, Hirofumi Ogawa, Yoshinori Ito, Hiroki Hara, Takashi Ura, Takashi Kojima, Keisho Chin, Shuichi Hironaka, Takayuki Kii, Yasushi Kojima, Yasunori Akutsu, Hisayuki Matsushita, Kentaro Kawakami, Keita Mori, Yushi Nagai, Chika Asami, Yuko Kitagawa
BACKGROUND: The standard treatment for locally advanced unresectable squamous cell carcinoma (SCC) of the oesophagus is chemoradiation with cisplatin and 5-fluorouracil (CF-RT). This multicentre phase II trial assessed the safety and efficacy of chemoselection with docetaxel plus cisplatin and 5-fluorouracil (DCF) induction chemotherapy (ICT) and subsequent conversion surgery (CS) for initially unresectable locally advanced SCC of the oesophagus. METHODS: Patients with clinical T4 and/or unresectable supraclavicular lymph node metastasis were eligible...
November 22, 2016: British Journal of Cancer
https://www.readbyqxmd.com/read/27806782/-modified-minimally-invasive-video-assisted-lateral-neck-dissection-for-papillary-thyroid-carcinoma-a-series-of-130-cases
#14
D G Zhang, L Gao, L Xie, G F He, L Fang, J Chen, Y W Miao, Z Z Wang
Objective: To discuss the feasibility, safety and oncologic completeness of modified minimally invasive video-assisted lateral neck dissection (MIVALND) for papillary thyroid carcinoma. Methods: Data of 130 patients from Department of Head and Neck Surgery, Sir Run Run Shaw Hospital, Medical School, Zhejiang University undergoing MIVALND from January 2013 to September 2015 were reviewed retrospectively. There were 31 male and 99 female patients with the mean age of (39±11) years. The thyroidectomy and central compartment dissection were performed under a direct visual field or video-assisted (VA) approach, lateral neck dissection was performed via the VA approach...
November 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27738822/the-role-of-laryngeal-electromyography-in-vagus-nerve-stimulation-related-vocal-fold-dysmotility
#15
Alberto M Saibene, Elena Zambrelli, Carlotta Pipolo, Alberto Maccari, Giovanni Felisati, Elena Felisati, Francesca Furia, Aglaia Vignoli, Maria Paola Canevini, Enrico Alfonsi
Vagus nerve stimulation (VNS) is a useful tool for drug-resistant epilepsy, but it induces known laryngeal side effects, with a significant role on patients' quality of life. VNS patients may show persistent left vocal fold (LVF) palsy at rest and/or recurrent LVF adduction during stimulation. This study aims at electromyographically evaluating laryngeal muscles abnormalities in VNS patients. We compared endoscopic laryngeal evaluation data in six VNS patients with laryngeal muscle electromyography (LMEMG) carried out on the thyroarytenoid, cricothyroid, posterior cricoarytenoid, and cricopharyngeal muscles...
October 13, 2016: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27680067/-application-of-mesoesophagus-suspension-technique-in-upper-mediastinal-lymph-node-dissection-during-thoracoscopic-esophagectomy
#16
Zhenyang Zhang, Qiancheng Song, Jiangbo Lin, Mingqiang Kang
OBJECTIVE: To explore the application of mesoesophagus suspension technique to improve the upper mediastinal lymph node dissection during thoracoscopic esophagectomy in the treatment of esophageal cancer. METHODS: Clinical data of 164 thoracic esophageal cancer patients who underwent combined thoracoscopic and laparoscopic esophagectomy with two-field lymph node dissection in the Union Hospital of Fujian Medical University between October 2012 and June 2015 were retrospectively analyzed...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27677565/improved-functional-results-after-minimally-invasive-esophagectomy-intrathoracic-versus-cervical-anastomosis
#17
Frans van Workum, Jolijn van der Maas, Frits J H van den Wildenberg, Fatih Polat, Ewout A Kouwenhoven, Marc J van Det, Grard A P Nieuwenhuijzen, Misha D Luyer, Camiel Rosman
BACKGROUND: Both cervical esophagogastric anastomosis (CEA) and intrathoracic esophagogastric anastomosis (IEA) are used to restore gastrointestinal integrity following minimally invasive esophagectomy (MIE). No prospective randomized data on functional outcome, postoperative morbidity, and mortality between these techniques are currently available. METHODS: A comparison was conducted including all consecutive patients with esophageal carcinoma of the distal esophagus or gastroesophageal junction undergoing MIE with CEA or MIE with IEA from October 2009 to July 2014 in 3 high-volume esophageal cancer centers...
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27651334/recurrent-laryngeal-nerve-management-in-thyroid-surgery-consequences-of-routine-visualization-application-of-intermittent-standardized-and-continuous-nerve-monitoring
#18
Angkoon Anuwong, Matteo Lavazza, Hoon Yub Kim, Che-Wei Wu, Stefano Rausei, Vincenzo Pappalardo, Cesare Carlo Ferrari, Davide Inversini, Andrea Leotta, Antonio Biondi, Feng-Yu Chiang, Gianlorenzo Dionigi
The objective is to compare the consequences of routine visualization (RV) and the application of intermitted (I-IONM), standardized (S-IONM), and continuous monitoring (C-IONM) of recurrent laryngeal nerve (RLN) management. RV includes that 698 RLNs managed solely with visual identification. In a second period 777, RLNs were handled by the I-IONM. The third period 768 RLNs monitoring was performed according to the standards. C-IONM via VN stimulation included 626 RLNs. The following issues were analyzed and compared per each period study: RLN identification rate, branching detection, assessment of NRLN, intraoperative recognizable nerve damage, stage thyroidectomy rate, transient or definitive lesions, bilateral nerve palsy, and recovery time...
December 2016: Updates in Surgery
https://www.readbyqxmd.com/read/27596752/quantitative-study-of-voice-dysfunction-after-thyroidectomy
#19
James C Lee, Daniel Breen, Amanda Scott, Simon Grodski, Meei Yeung, William Johnson, Jonathan Serpell
BACKGROUND: Up to 80% of patients without a recurrent laryngeal nerve palsy report alteration in their voice after a thyroid procedure. The aims of this study were (1) to quantify voice changes after thyroid operation; (2) to correlate the changes to the extent of operation; and (3) to correlate voice changes to intraoperative recurrent laryngeal nerve swelling. METHODS: Patients undergoing total and hemithyroidectomy were recruited prospectively from the Monash University Endocrine Surgery Unit during a 12-month period...
December 2016: Surgery
https://www.readbyqxmd.com/read/27566947/-the-final-countdown-is-intraoperative-intermittent-neuromonitoring-really-useful-in-preventing-permanent-nerve-palsy-evidence-from-a-meta-analysis
#20
REVIEW
Celestino Pio Lombardi, Giulia Carnassale, Gianfranco Damiani, Anna Acampora, Marco Raffaelli, Carmela De Crea, Rocco Bellantone
BACKGROUND: The aim of our research was to explore the specific role of intermittent intraoperative neuromonitoring (IONM) versus visualization alone in preventing permanent nerve palsy in thyroid surgery. METHODS: A systematic review was conducted by searching electronic databases using specific keywords and completed by hand search. The article selection process was carried out by 2 independent investigators using well-defined inclusion and exclusion criteria...
December 2016: Surgery
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