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Recurrent laryngeal nerve palsy

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https://www.readbyqxmd.com/read/29332349/characteristics-and-clinical-significance-of-recurrent-laryngeal-nerve-lymph-node-metastasis-in-esophageal-squamous-cell-carcinoma
#1
Longfei Ma, Jiaqing Xiang, Yawei Zhang, Hong Hu, Rongrong Shao, Dong Lin
PURPOSE: The recurrent laryngeal nerve lymph nodes (RLN LNs) are among the most common metastatic sites in esophageal cancer, and the dissection of these lymph nodes (LNs) is considered beneficial. The purpose of this study was to evaluate the characteristics of RLN LN metastases from esophageal squamous cell carcinoma, and the effects of these metastases on the prognosis of patients. In addition, we aimed to determine the reasonable range of dissection of regional LNs. METHODS: The clinical data from 348 patients who underwent resection for esophageal carcinoma were retrospectively analyzed...
November 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29303067/modified-tumescent-solution-for-creating-working-space-during-endoscopic-thyroidectomy
#2
Li-Yong Zhang, Wen-Xin Zhao, Bo Wang, Shou-Yi Yan, Jia Wen
OBJECTIVE: To study the feasibility of gas-liquid mixing tumescent solution for creating a working space (WS) in endoscopic thyroidectomy (ET). MATERIALS AND METHODS: A prospective study was performed on 186 patients with thyroid tumor who had undergone ET via chest and breast approach. Patients were randomly divided into 2 groups to receive traditional tumescent solution as group A and modified tumescent solution (gas-liquid mixing tumescent solution) as group B...
January 1, 2018: Surgical Innovation
https://www.readbyqxmd.com/read/29302725/does-surgery-without-lugol-s-solution-pretreatment-for-graves-disease-increase-surgical-morbidity
#3
Frederic Mercier, Mathieu Bonnal, Florian Fanget, Laure Maillard, Nathalie Laplace, Jean-Louis Peix, Jean-Christophe Lifante
BACKGROUND: Total thyroidectomy can be performed for Graves' disease after a euthyroid state is achieved using inhibitors of thyroid hormone synthesis (thioamides). However, hypervascularization of the thyroid gland is associated with increased hemorrhage risk, in addition to complicating identification of the recurrent laryngeal nerve and parathyroid gland. Saturated iodine solution (Lugol's solution) has been recommended to reduce thyroid gland hypervascularization and intraoperative blood loss, although this approach is not used at our center based on our experience that it induces thyroid firmness and potentially hypoparathyroidism...
January 4, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29299645/transcutaneous-laryngeal-ultrasonography-for-laryngeal-immobility-diagnosis-in-patients-with-voice-disorders-after-thyroid-parathyroid-surgery
#4
Diane S Lazard, Héloïse Bergeret-Cassagne, Muriel Lefort, Laurence Leenhardt, Gilles Russ, Frédérique Frouin, Christophe Trésallet
BACKGROUND: Transcutaneous laryngeal ultrasonography (TLUS) was recently developed to assess recurrent nerve palsy after thyroid/parathyroid surgery, with variable rates of efficiency. The aim of the current study was to evaluate this technique using subjective estimation and post-processing quantitative data. METHODS: Fifty subjects presenting with a recurrent nerve palsy and 50 "controls" presenting with voice, swallowing, or breathing disorders following thyroid/parathyroid surgery were prospectively included...
January 3, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29282507/recovery-of-voice-after-reconstruction-of-the-recurrent-laryngeal-nerve-and-adjuvant-nimodipine
#5
P Mattsson, A Frostell, G Björck, J K E Persson, R Hakim, J Zedenius, M Svensson
BACKGROUND: Transection injury to the recurrent laryngeal nerve (RLN) has been associated with permanent vocal fold palsy, and treatment has been limited to voice therapy or local treatment of vocal folds. Microsurgical repair has been reported to induce a better function. The calcium channel antagonist nimodipine improves functional recovery after experimental nerve injury and also after cranial nerve injury in patients. This study aims to present voice outcome in patients who underwent repair of the RLN and received nimodipine during regeneration...
December 28, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29207852/the-efficacy-and-safety-of-high-intensity-focused-ultrasound-ablation-of-benign-thyroid-nodules
#6
Brian H Lang, Arnold L H Wu
High-intensity focused ultrasound (HIFU) is a promising form of thermal ablation of benign thyroid nodules, but evidence supporting its use is scarce. The present review evaluated the efficacy and safety of single-session HIFU treatment of benign thyroid nodules. As reported in the literature, the extent of nodule shrinkage following treatment ranged from 48.8% to 68.8%. Like other forms of ablation, the shrinkage rate was greatest in the first 3-6 months, and the best responders were patients with small (≤10 mL) nodules...
October 10, 2017: Ultrasonography
https://www.readbyqxmd.com/read/29187691/-tapia-s-syndrome-following-transesophageal-echocardiography-during-an-open-heart-operation-a-case-report
#7
Satoru Fujiwara, Hajime Yoshimura, Kenta Nishiya, Keiichi Oshima, Michi Kawamoto, Nobuo Kohara
A 67-year-old man presented with hoarseness, dysarthria and deviation of the tongue to the left side the day after the open-heart operation under general anesthesia. Brain MRI demonstrated no causal lesion, and laryngoscope showed left vocal cord abductor palsy, so we diagnosed him with Tapia's syndrome (i.e., concomitant paralysis of the left recurrent and hypoglossal nerve). His neurological symptoms recovered gradually and improved completely four months after the onset. Tapia's syndrome is a rare condition caused by the extra cranial lesion of the recurrent laryngeal branch of the vagus nerve and the hypoglossal nerve, and mostly described as a complication of tracheal intubation...
November 28, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/29174858/visualized-evaluation-of-blood-flow-to-the-gastric-conduit-and-complications-in-esophageal-reconstruction
#8
Kazuhiro Noma, Yasuhiro Shirakawa, Nobuhiko Kanaya, Tsuyoshi Okada, Naoaki Maeda, Takayuki Ninomiya, Shunsuke Tanabe, Kazufumi Sakurama, Toshiyoshi Fujiwara
BACKGROUND: Evaluation of the blood supply to gastric conduits is critically important to avoid complications following esophagectomy. We commenced visualized evaluation of blood flow using indocyanine green (ICG) fluorescent imaging from July 2015, to reduce reconstructive complications. In this study, we aimed to statistically verify the efficacy of blood flow evaluation using our simplified ICG method. STUDY DESIGN: A total of 285 consecutive patients who underwent esophagectomy and gastric conduit reconstruction were reviewed and divided into two groups: before and after introduction of ICG evaluation...
November 22, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29162343/long-term-voice-quality-outcomes-after-total-thyroidectomy-a-prospective-multicenter-study
#9
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
#10
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
#11
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
#12
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
#13
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...
January 2018: Surgery
https://www.readbyqxmd.com/read/29124033/intraoperative-recurrent-laryngeal-nerve-monitoring-in-a-patient-with-contralateral-vocal-fold-palsy
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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