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Recurrent laryngeal nerve palsy

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https://www.readbyqxmd.com/read/29162343/long-term-voice-quality-outcomes-after-total-thyroidectomy-a-prospective-multicenter-study
#1
Frédéric Borel, Niki Christou, Olivier Marret, Muriel Mathonnet, Cécile Caillard, Sahar Bannani, Delphine Drui, Florent Espitalier, Claire Blanchard, Eric Mirallié
BACKGROUND: Postthyroidectomy voice disorders can occur without any recurrent laryngeal nerve injury, and probably are the most frequent complication after thyroidectomy. We report the long-term voice quality outcomes after total thyroidectomy without vocal cord palsy using a simple self-assessment tool: the voice handicap index self-questionnaire. METHODS: This observational prospective multicenter study included 203 patients from the "ThyrQoL" study (ClinicalTrial NCT02167529), who underwent total thyroidectomy between October 2014 and August 2015 in 3 French Hospitals (Nantes, La Roche-sur-Yon, and Limoges)...
November 18, 2017: Surgery
https://www.readbyqxmd.com/read/29142846/opportunities-and-challenges-of-intermittent-and-continuous-intraoperative-neural-monitoring-in-thyroid-surgery
#2
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/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/29128183/does-intraoperative-neuromonitoring-of-recurrent-nerves-have-an-impact-on-the-postoperative-palsy-rate-results-of-a-prospective-multicenter-study
#5
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/29124033/intraoperative-recurrent-laryngeal-nerve-monitoring-in-a-patient-with-contralateral-vocal-fold-palsy
#6
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/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
#7
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/29110082/continuous-monitoring-of-the-recurrent-laryngeal-nerve
#8
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/29095795/role-of-reinnervation-in-the-management-of-recurrent-laryngeal-nerve-injury-current-state-and-advances
#9
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/29076277/robotic-surgery-for-the-upper-gastrointestinal-tract-current-status-and-future-perspectives
#10
REVIEW
Masaya Nakauchi, Ichiro Uyama, Koichi Suda, Mohamed Mahran, Tetsuya Nakamura, Susumu Shibasaki, Kenji Kikuchi, Shinichi Kadoya, Kazuki Inaba
More than 4000 da Vinci Surgical Systems have been installed worldwide. Robotic surgery using the da Vinci Surgical System has been increasingly performed in the last decade, especially in urology and gynecology. The da Vinci Surgical System has not become standard in surgery of the upper gastrointestinal tract because of a lack of clear benefits in comparison with conventional minimally invasive surgery. We initiated robotic gastrectomy and esophagectomy for patients with upper gastrointestinal cancer in 2009, and we have demonstrated the potential advantages of the da Vinci Surgical System in reducing postoperative local complications after gastrectomy and recurrent laryngeal nerve palsy after esophagectomy...
November 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29057356/anterior-cervical-spine-surgery-associated-complications-in-a-retrospective-case-control-study
#11
REVIEW
Anastasia Tasiou, Theofanis Giannis, Alexandros G Brotis, Ioannis Siasios, Iordanis Georgiadis, Haralampos Gatos, Eleni Tsianaka, Konstantinos Vagkopoulos, Konstantinos Paterakis, Kostas N Fountas
Anterior cervical spine procedures have been associated with satisfactory outcomes. However, the occurrence of troublesome complications, although uncommon, needs to be taken into consideration. The purpose of our study was to assess the actual incidence of anterior cervical spine procedure-associated complications and identify any predisposing factors. A total of 114 patients undergoing anterior cervical procedures over a 6-year period were included in our retrospective, case-control study. The diagnosis was cervical radiculopathy, and/or myelopathy due to degenerative disc disease, cervical spondylosis, or traumatic cervical spine injury...
September 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29039144/transoral-endoscopic-thyroidectomy-via-a-vestibular-approach-why-and-how
#12
Gianlorenzo Dionigi, Young Jun Chai, Ralph P Tufano, Angkoon Anuwong, Hoon Yub Kim
The transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a novel, scar-free surgical procedure that does not require visible incisions. Indications for TOETVA are as follows: predicted gland width on diagnostic imaging ≤10 cm; a thyroid volume outline of <45 mL or dominant nodule dimension of ≤50 mm; three or four Bethesda lesions; a primary papillary microcarcinoma without local or distant metastasis; and patient request for optimal esthetic results. Contraindications are as follows: patients unfit for general anesthesia; precedent radiation in the head, neck, upper mediastinum; antecedent neck surgery; recurrent goiter; a gland volume of >45 mL or main nodule diameter of >50 mm; and documentation of lymph node or distant metastases, tracheal/esophageal infiltration, preoperative laryngeal nerve palsy, hyperthyroidism, mediastinal goiter, or an oral abscess...
October 16, 2017: Endocrine
https://www.readbyqxmd.com/read/29030215/analyzing-cost-effectiveness-of-neural-monitoring-in-recurrent-laryngeal-nerve-recovery-course-in-thyroid-surgery
#13
Tie Wang, Hoon Yub Kim, Che-Wei Wu, Stefano Rausei, Hui Sun, Francesca Pia Pergolizzi, Gianlorenzo Dionigi
PURPOSE: The increasing use of intraoperative neural monitoring (IONM) of the recurrent laryngeal nerve (RLN) during thyroid surgery imposes an evaluation of cost-effectiveness. METHODS: The analysis estimated the cost versus utility of different alternatives that simulate nerve injury course and the consequences for the following cohorts of patients: (1) no RLN injury, or vocal fold palsy (VCP) recovery within 1 month (2), 2 months (3), 6 months (4), and after 12 months (5)...
October 10, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29030129/laryngeal-and-vocal-alterations-after-thyroidectomy
#14
Renata Mizusaki Iyomasa, José Vicente Tagliarini, Sérgio Augusto Rodrigues, Elaine Lara Mendes Tavares, Regina Helena Garcia Martins
INTRODUCTION: Dysphonia is a common symptom after thyroidectomy. OBJECTIVE: To analyze the vocal symptoms, auditory-perceptual and acoustic vocal, videolaryngoscopy, the surgical procedures and histopathological findings in patients undergoing thyroidectomy. METHODS: Prospective study. Patients submitted to thyroidectomy were evaluated as follows: anamnesis, laryngoscopy, and acoustic vocal assessments. Moments: pre-operative, 1st post (15 days), 2nd post (1 month), 3rd post (3 months), and 4th post (6 months)...
September 21, 2017: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28988275/risk-factors-and-preventative-measures-of-early-and-persistent-dysphagia-after-anterior-cervical-spine-surgery-a-systematic-review
#15
REVIEW
Jingwei Liu, Yong Hai, Nan Kang, Xiaolong Chen, Yangpu Zhang
PURPOSE: To conduct a systematic review of literature to determine risk factors and preventative measures of early and persistent dysphagia after anterior cervical spine surgery (ACSS). METHODS: On March 2017, we searched the database PubMed, Medline, EMBASE, the Cochrane library, Clinical key, Springer link and Wiley Online Library without time restriction using the term 'dysphagia', 'swallowing disorders', and 'anterior cervical spine surgery'. Selected papers were examined for the level of evidence by published guidelines as level I, level II, level III, level IV studies...
October 7, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28986621/modification-of-the-surgical-strategy-for-the-dissection-of-the-recurrent-laryngeal-nerve-using-continuous-intraoperative-nerve-monitoring
#16
Andres Marin Arteaga, Giuseppe Peloni, Igor Leuchter, Benoit Bedat, Wolfram Karenovics, Frederic Triponez, Samira Mercedes Sadowski
BACKGROUND: The aim of this study was to describe first experiences and changes in management using continuous intraoperative neuromonitoring (C-IONM) in thyroid and parathyroid surgery. METHOD: Retrospective analysis of patients who underwent surgery with C-IONM since 2012. Surgical maneuvers were modified when electrophysiologic events occurred. Patients with persistent loss of signal (LOS) underwent postoperative laryngoscopy. RESULTS: One hundred and one patients (of 1586 neck surgeries) were included and 19 had events: In 13 these were temporary (resolved before end of surgery) and led to intraoperative modifications in surgical approach; in all cases traction was released, and in 8, recurrent laryngeal nerve (RLN) approach was changed [superior approach (2), inferior approach (2), both (4)]...
October 6, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28962821/comparison-of-emg-signals-recorded-by-surface-electrodes-on-endotracheal-tube-and-thyroid-cartilage-during-monitored-thyroidectomy
#17
Feng-Yu Chiang, I-Cheng Lu, Pi-Ying Chang, Gianlorenzo Dionigi, Gregory W Randolph, Hui Sun, Kang-Dae Lee, Kyung Tae, Yong Bae Ji, Sung Won Kim, Hyoung Shin Lee, Che-Wei Wu
A variety of electromyography (EMG) recording methods were reported during intraoperative neural monitoring (IONM) of recurrent laryngeal nerve (RLN) in thyroid surgery. This study compared two surface recording methods that were obtained by electrodes on endotracheal tube (ET) and thyroid cartilage (TC). This study analyzed 205 RLNs at risk in 110 patients undergoing monitored thyroidectomy. Each patient was intubated with an EMG ET during general anesthesia. A pair of single needle electrode was inserted obliquely into the TC lamina on each side...
October 2017: Kaohsiung Journal of Medical Sciences
https://www.readbyqxmd.com/read/28953673/evaluation-of-clinical-significance-and-risk-factors-of-incidental-parathyroidectomy-due-to-thyroidectomy-a-single-center-retrospective-clinical-study
#18
Jianwei Zheng, Huimin Song, Shuyan Cai, Yunlei Wang, Xiaofeng Han, Haoliang Wu, Zhigang Gao, Fanrong Qiu
We assessed the clinical significance and risk factors of incidental parathyroidectomy during total thyroidectomy with or without central neck dissection or subtotal thyroidectomy.Retrospective analysis of clinical and pathological features of 548 consecutive thyroidectomy cases was compared by grouping into inadvertent resection (IR, n = 86) with IR of parathyroid glands, non-IR (n = 462) without, and then into postoperative hypoparathyroidism (PH, n = 140) with PH and non-PH (n = 408) without...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28944327/extralaryngeal-division-of-the-recurrent-laryngeal-nerve-a-common-and-asymmetric-anatomical-variant
#19
Mehmet Uludağ, Gürkan Yetkin, Ebru Şen Oran, Nurcihan Aygün, Fevzi Celayir, Adnan İşgör
OBJECTIVE: Recognition of extralaryngeal branching of the recurrent laryngeal nerve is crucial because prevention of vocal cord paralysis requires preservation of all branches of the recurrent laryngeal nerve. We assessed the prevalence of extralaryngeal branching of the recurrent laryngeal nerve and the median branching distance from the point of bifurcation to the entry point of the nerve into the larynx. MATERIAL AND METHODS: Prospective operative data on recurrent laryngeal nerve branching were collected from 94 patients who underwent thyroid or parathyroid surgery between September 2011 and May 2012...
2017: Turk J Surg
https://www.readbyqxmd.com/read/28929066/surgical-treatment-of-retrosternal-goitre
#20
Kiera Welman, Richard Heyes, Paras Dalal, Sarah Hough, Marciano Bunalade, Vladimir Anikin
This study aims to evaluate surgical approaches to the management of retrosternal goitre. Between 2004 and 2014, 35 patients (eight males; mean age 67.4 ± 10.9 years) with retrosternal goitre (mainly right-sided in 9, left-sided in 14 and bilateral in 12) underwent surgery. A palpable neck mass was found in 11 (31.4%), stridor in 10 (28.6%) and thyrotoxicosis in 4 (11.4%) cases. 4 (11.4%) patients were asymptomatic. Tracheal compression was detected radiologically in 27 (77.2%) patients with deviation in 18 (51...
September 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
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