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laryngeal nerve thyroidectomy

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https://www.readbyqxmd.com/read/28105483/gastric-acid-secretion-and-gastrin-release-during-continuous-vagal-neuromonitoring-in-thyroid-surgery
#1
Liu Xiaoli, Che-Wei Wu, Hoon Yub Kim, Wen Tian, Feng-Yu Chiang, Renbin Liu, Angkoon Anuwong, Gregory W Randolph, Gianlorenzo Dionigi, Matteo Lavazza
PURPOSE: The vagus nerve (VN) has essential regulatory roles in the gastric acid secretion and gastrin release. Continuous intraoperative neuromonitoring (CIONM) via VN stimulation is a promising technique in thyroid surgery because it potentially avoids injury to the recurrent laryngeal nerve. However, no studies have investigated changes in gastric acid secretion and gastrin release during CIONM. METHOD: This prospective study of 58 thyroid surgery patients compared gastric acid and serum gastrin at five time points: (1) before skin incision, (2) after baseline calibration of CIONM probe, (3) +20 min from baseline, (4) before probe removal, and (5) after extubation...
January 19, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28049375/comparative-effectiveness-of-treatment-choices-for-graves-hyperthyroidism-a-historical-cohort-study
#2
Vishnu Sundaresh, Juan P Brito, Prabin Thapa, Rebecca S Bahn, Marius N Stan
Introduction The optimum therapy for Graves' Disease (GD) is chosen following discussion between physician and patient regarding benefits, drawbacks, potential side effects, and logistics of the various treatment options and takes into account patient values and preferences. This cohort study aimed to provide useful information for this discussion regarding the usage, efficacy and adverse effect profile of radioactive iodine (RAI), antithyroid drugs (ATDs), and thyroidectomy in a tertiary healthcare facility...
January 3, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28035477/contribution-of-intraoperative-neural-monitoring-to-preservation-of-the-external-branch-of-the-superior-laryngeal-nerve-a-randomized-prospective-clinical-trial
#3
Mehmet Uludag, Nurcihan Aygun, Kinyas Kartal, Bulent Citgez, Evren Besler, Gurkan Yetkin, Cemal Kaya, Hamdi Ozsahin, Mehmet Mihmanli, Adnan Isgor
PURPOSE: The purpose of this study was to evaluate the effect of intraoperative neuromonitoring (IONM) on the injury rate of the external branch of the superior laryngeal nerve (EBSLN) during thyroidectomy. METHODS: A total of 133 consenting patients (98 female, 35 male; mean age, 45.6 ± 11.7 years) undergoing thyroidectomy were randomly assigned to 2 groups. In group 1 (n = 65 patients, 105 nerves), superior thyroid pole dissection was performed with no attempt to identify the EBSLN; in group 2 (n = 68 patients, 106 nerves), IONM was used to identify the EBSLN during surgery...
December 29, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28034775/systematic-review-and-meta-analysis-on-intra-operative-neuro-monitoring-in-high-risk-thyroidectomy
#4
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
#5
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/28003944/role-of-intraoperative-nerve-monitoring-during-parathyroidectomy-to-prevent-recurrent-laryngeal-nerve-injury
#6
REVIEW
Usman Ghani, Salman Assad, Shuja Assad
Injury to the recurrent laryngeal nerve (RLN) is a well known, though less frequent, complication of parathyroid surgery. In recent years, the use of intraoperative nerve monitoring (IONM) has gained popularity amongst surgeons when operating on thyroid gland; however, its utilization in parathyroid surgery is not established. This trend continues to rise, despite multiple studies documenting no statistically significant difference that IONM decreases the incidence of RLN injury. Most surgeons use this technology as an adjunct to visualization alone for identification of RLN...
November 15, 2016: Curēus
https://www.readbyqxmd.com/read/27997055/role-of-immediate-recurrent-laryngeal-nerve-reconstruction-in-surgery-for-thyroid-cancers-with-fixed-vocal-cords
#7
Shinobu Iwaki, Tatsuyoshi Maeda, Miki Saito, Naoki Otsuki, Miki Takahashi, Emi Wakui, Hirotaka Shinomiya, Koichi Morimoto, Hiroyuki Inoue, Hiroo Masuoka, Akira Miyauchi, Ken-Ichi Nibu
BACKGROUND: Quality of voice after immediate recurrent laryngeal nerve (RLN) reconstruction in thyroid cancers has not been thoroughly studied. METHODS: Thirteen patients with fixed vocal cords (fixed vocal cord group) and 8 patients with intact or impaired mobile vocal cords (mobile vocal cord group) who had immediate RLN reconstruction simultaneously with total thyroidectomy, and patients who had arytenoid adduction and thyroplasty for vocal cord paralysis caused by previous surgery (arytenoid adduction thyroplasty group) were enrolled in this study...
December 20, 2016: Head & Neck
https://www.readbyqxmd.com/read/27941961/therapeutic-effects-of-bipolar-coagulation-forceps-on-open-thyroid-surgery
#8
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
#9
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/27867862/intermittent-neural-monitoring-of-the-recurrent-laryngeal-nerve-in-surgery-for-recurrent-goiter
#10
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/27866716/can-we-consider-immediate-complications-after-thyroidectomy-as-a-quality-metric%C3%A2-of-operation
#11
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/27846184/minimal-endoscope-assisted-thyroidectomy-through-a-retroauricular-approach-an-evolving-solo-surgery-technique
#12
Myung Jin Ban, Jae Won Chang, Won Shik Kim, Hyung Kwon Byeon, Yoon Woo Koh, Jae Hong Park
This study aimed to evaluate the feasibility and efficacy of minimal endoscope-assisted thyroidectomy (MEAT) through a retroauricular (RA) approach. Most of the thyroidectomy operative time was accounted for by direct visualization through the RA window, minimizing interference between surgical instruments. Endoscope use was minimized and limited to critical surgical aspects, including preservation of the recurrent laryngeal nerve and parathyroid glands. The recurrent laryngeal nerve was neuromonitored throughout the procedure...
December 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27818960/vocal-fold-mobility-alteration-reversed-after-thyroidectomy
#13
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/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/27774578/propensity-score-matched-analysis-of-robotic-versus-endoscopic-bilateral-axillo-breast-approach-baba-thyroidectomy-in-papillary-thyroid-carcinoma
#15
Seo Ki Kim, Jung-Woo Woo, Inhye Park, Jun Ho Lee, Jun-Ho Choe, Jung-Han Kim, Jee Soo Kim
PURPOSE: The da Vinci surgical robot system was developed to overcome the weaknesses of endoscopic surgery. However, whether robotic surgery is superior to endoscopic surgery remains uncertain. Therefore, the purpose of this study was to compare the surgical and oncologic outcomes between endoscopic and robotic thyroidectomy using bilateral axillo-breast approach (BABA). METHODS: Between January 2008 and June 2015, papillary thyroid carcinoma patients who underwent thyroidectomy with central neck dissection using endoscopic (n = 480) or robotic (n = 705) BABA were primarily reviewed...
October 24, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27738835/remote-access-robotic-facelift-thyroidectomy-a-multi-institutional-experience
#16
William S Duke, F Christopher Holsinger, Emad Kandil, Jeremy D Richmon, Michael C Singer, David J Terris
BACKGROUND: Robotic facelift thyroidectomy (RFT) was developed as a new surgical approach to the thyroid gland using a remote incision site. Early favorable results led to this confirmatory multi-institutional experience. METHODS: Prospectively collected data on consecutive patients undergoing RFT in five North American academic endocrine surgical practices were compiled. Surgical indications, operative times, final pathology, nodule size, complications, and postoperative management (drain use and length of hospital stay) were evaluated...
January 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/27737451/a-cost-utility-analysis-of-recurrent-laryngeal-nerve-monitoring-in-the-setting-of-total-thyroidectomy
#17
Daniel J Rocke, David P Goldstein, John R de Almeida
Importance: Intraoperative nerve monitoring (IONM) of the recurrent laryngeal nerve (RLN) is used as a tool to decrease the rate of nerve injury, although study findings are divergent on IONM efficacy. The cost-effectiveness of this approach to total thyroidectomy has not been well studied. Objective: To determine whether IONM is a cost-effective intervention in the setting of total thyroidectomy. Design and Setting: This study creates a decision-tree model of total thyroidectomy to analyze, from a societal perspective, the cost-effectiveness of universal IONM (ie, use in every case) vs selective IONM (ie, high-risk cases including reoperative cases, substernal or toxic goiters, and cases with known cancer) vs no IONM (visual identification only)...
December 1, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27720825/importance-of-latency-and-amplitude-values-of-recurrent-laryngeal-nerve-during-thyroidectomy-in-diabetic-patients
#18
Ibrahim Ali Ozemir, Ferman Ozyalvac, Gorkem Yildiz, Tunc Eren, Zeynep Aydin-Ozemir, Orhan Alimoglu
BACKGROUND: Diabetes mellitus may cause degeneration in the myelin and/or axonal structures of peripheral nerves. The aim of this study was to investigate the effects of diabetic neuropathy on intraoperative neuromonitoring findings such as latency and amplitude values of the recurrent laryngeal nerves during thyroidectomy. To our knowledge this is the first study to report comparison of the electrophysiologic features of diabetic and non-diabetic patients. MATERIALS AND METHODS: One-hundred-and-eleven consecutive patients who received neuromonitoring during thyroidectomy between 2013 and 2015 were included to study...
November 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27682264/intraoperative-neuromonitoring-in-thyroidectomy-the-learning-curve
#19
Paolo Del Rio, Piercosimo Nisi, Sara Benedicenti, Elisa Bertocchi, Enrico Luzietti, Mario Sianesi
AIM: To evaluate the learning curve in the use of intraoperative neuromonitoring of recurrent laryngeal nerve and vagus in thyroid surgery. MATERIALS OF THE STUDY: We analyzed 140 pts treated consecutively for thyroid disease. All the patients were neuromonitored with Intraoperative neuromonitoring of recurrent laryngeal nerve and vagus. We divided these patients in 7 groups to collect the adverse events during our learning curve. RESULTS: We monitored consecutively 271 nerves...
2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27677707/total-thyroidectomy-versus-thyroid-lobectomy-for-papillary-thyroid-cancer-comparative-analysis-after-propensity-score-matching-a-multicenter-study
#20
Sayaka Kuba, Kosho Yamanouchi, Naomi Hayashida, Shigeto Maeda, Toshiyuki Adachi, Chika Sakimura, Fusako Kawakami, Hiroshi Yano, Megumi Matsumoto, Ryota Otsubo, Shuntaro Sato, Hikaru Fujioka, Tamotsu Kuroki, Takeshi Nagayasu, Susumu Eguchi
BACKGROUND: In patients with papillary thyroid carcinoma (PTC), the role of total thyroidectomy (TT) versus that of thyroid lobectomy (TL) has been controversial. METHODS: This retrospective study was approved by our institutional review board, and the requirement to obtain informed consent was waived. In total, 173 patients with 1- to 5-cm stage cN0 and cM0 PTC tumors treated by curative surgery from 1994 to 2008 were evaluated. Clinicopathologic features and adverse events were compared between patients who underwent TT and those who underwent TL...
September 24, 2016: International Journal of Surgery
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