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laryngeal nerve thyroidectomy

Xiao-Chun Mao, Chao Chen, Ke-Jing Wang
PURPOSE: To compare the efficacy and safety profiles of LigaSure™ small jaw instrument (LSJI) versus conventional technique in patients undergoing open thyroidectomy. METHODS: This single-center, prospective, observational study conducted in Zhejiang Provincial Cancer Hospital enrolled patients who underwent thyroidectomy between September 2013 and September 2014. The primary study outcomes included determination of blood loss, operative duration, length of hospital stay, and drainage volume...
March 13, 2018: European Archives of Oto-rhino-laryngology
Xiaoli Liu, Daqi Zhang, Guang Zhang, Lina Zhao, Le Zhou, Yantao Fu, Shijie Li, Yishen Zhao, Changlin Li, Che-Wei Wu, Feng-Yu Chiang, Gianlorenzo Dionigi, Hui Sun
AIM: We assess the prevalence and mechanism of recurrent laryngeal nerve (RLN) injury in central neck dissection (CND) for thyroid cancer. METHODS: CND with intraoperative neural monitoring was outlined in 1.273 nerves at risk (NAR). RLN lesions were stratified according to: timing (during thyroidectomy versus CND), segmental vs. diffuse injury, mechanism, severity, location, number of lymph nodes dissected and metastastatic. EMG parameters were recorded. RESULTS: 49/1...
January 31, 2018: Surgical Oncology
Lawrence Chen, Yi-Hsiu Wu, Chia-Hwa Lee, Hsin-An Chen, El-Wui Loh, Ka-Wai Tam
BACKGROUND: Central neck dissection and total thyroidectomy are standard treatments for patients with papillary thyroid carcinoma (PTC) with clinically involved central nodes. However, prophylactic central neck dissection (pCND) in patients with clinically uninvolved cN0 has been beneficial in some studies but ineffective in others. We conducted a meta-analysis to evaluate the efficacy and safety of pCND in patients with central neck lymph nodes cN0 PTC. METHODS: The PubMed, EMBASE, Cochrane Library, and Scopus databases and the ClinicalTrials...
February 27, 2018: World Journal of Surgery
Ismail Cem Sormaz, Fatih Tunca, Yasemin Giles Şenyürek
PURPOSE: To evaluate the bilateral patterns and motor function of the extralaryngeal branches (ELB) of the recurrent laryngeal nerve(RLN). METHODS: This study included 500 consecutive patients who underwent total thyroidectomy. Intraoperative nerve monitoring (IONM) was used in 230 patients. Demographic data, indications for surgery, the bilateral patterns of ELB of the RLN, electromyographic activity of the ELB, distance between the branching point to the entrance into the larynx, and the rate of postoperative morbidity were analyzed...
February 21, 2018: Surgical and Radiologic Anatomy: SRA
Christopher E Fundakowski, Nathan W Hales, Nishant Agarwal, Marcin Barczyński, Pauline M Camacho, Dana M Hartl, Emad Kandil, Whitney E Liddy, Travis J McKenzie, John C Morris, John A Ridge, Rick Schneider, Jonathan Serpell, Catherine F Sinclair, Samuel K Snyder, David J Terris, R Michael Tuttle, Che-Wei Wu, Richard J Wong, Mark Zafereo, Gregory W Randolph
"I have noticed in operations of this kind, which I have seen performed by others upon the living, and in a number of excisions, which I have myself performed on the dead body, that most of the difficulty in the separation of the tumor has occurred in the region of these ligaments…. This difficulty, I believe, to be a very frequent source of that accident, which so commonly occurs in removal of goiter, I mean division of the recurrent laryngeal nerve." Sir James Berry (1887).
February 20, 2018: Head & Neck
SeungWon Lee, KiNam Park
OBJECTIVES: This study compared and assessed long-term voice outcomes when thyroidectomy-related unilateral vocal fold paralysis (VFP) was managed using injection laryngoplasty (IL) and recurrent laryngeal nerve reinnervation (RLNR). STUDY DESIGN: Prospective clinical study. METHODS: A prospective clinical trial was performed from March 2005 to January 2016 at Soonchunhyang University Bucheon Hospital (Bucheon, South Korea). Nineteen patients who underwent ansa cervicalis to RLNR or direct reinnervation, and 43 patients who underwent IL to treat thyroidectomy-related unilateral VFP, were enrolled...
February 16, 2018: Laryngoscope
Gianlorenzo Dionigi, Che-Wei Wu, Ralph P Tufano, Antonio Giacomo Rizzo, Angkoon Anuwong, Hui Sun, Paolo Carcoforo, Cancellieri Antonino, Mattia Portinari, Hoon Yub Kim
This video aimed to describe the role of intraoperative neuromonitoring (IONM) during transoral endoscopic thyroidectomy vestibular approach (TOETVA) with emphasis given to IONM technical and technological notes, the identification of recurrent laryngeal nerve (RLN). Standardized technique of IONM consist in identifying and monitoring both the vagus nerve and the RLNs before and after resection (V1, V2, R1, R2). According to this report, IONM during TOETVA is feasible and safe in providing identification and function of laryngeal nerves...
2018: Journal of Visualized Surgery
Kyle Zanocco, David J Kaltman, James X Wu, Abbey Fingeret, Keith S Heller, James A Lee, Michael W Yeh, Julie Ann Sosa, Cord Sturgeon
BACKGROUND: Some surgeons perform flexible fiberoptic laryngoscopy (FFL) in all patients prior to thyroid cancer operations. Given the low likelihood of recurrent laryngeal nerve (RLN) or aerodigestive invasion in clinically low-risk thyroid cancers, the value of routine FFL in this group is controversial. We hypothesized that routine preoperative FFL would not be cost effective in low-risk differentiated thyroid cancer (DTC). METHODS: A decision model was constructed comparing preoperative FFL versus surgery without FFL in a clinical stage T2 N0 DTC patient without voice symptoms...
February 7, 2018: Annals of Surgical Oncology
Q Z Zhao, Y Wang, P Wang
Objective: To evaluate the feasibility, safety and efficacy of endoscopic thyroidectomy in the treatment of papillary thyroid carcinoma through clinical follow-up. Methods: Patients who underwent total thyroidectomy and had a final pathologic diagnosis of papillary thyroid carcinoma at Department of Thyroid Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine between February 2013 and April 2014 were enrolled in this study; those who had family history of thyroid cancer or a history of radiation of the neck area were excluded...
February 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Liqun Shan, Jianing Liu
BACKGROUND: Transoral thyroidectomy is a kind of "natural orifice transluminal endoscopic surgery (NOTES)" which is now being performed in increasing frequency. However, the safety and feasibility have not been concluded yet. MATERIALS AND METHODS: A systemic literature search was performed in Pubmed, Cochrane, and Embase databases to identify all studies written in English and published up to April 2017. The keywords used were "transoral endoscopic," "transoral robotic," "oral vestibular endoscopic," and "oral vestibular robotic" combined with "thyroidectomy" or "thyroid surgery...
January 31, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Theodoros Piperos, Ioannis Kaklamanos, Dimosthenis Chrysikos, Maria Zarokosta, Eleni Boumpa, Menelaos Zoulamoglou, Vasileios Kalles, Georgia-Ioanna Gkogka, Theodoros Mariolis-Sapsakos
The extralaryngeal bifurcation point of the recurrent laryngeal nerve (RLN) is typically located in a mean distance of 0-2 cm from the cricothyroid joint (CTJ). In the presented case though, the left RLN was unexpectedly identified bifurcating in a mean distance of 7 cm from the left CTJ in a young woman with multinodular goiter during total thyroidectomy. The RLN was carefully exposed throughout its course for the avoidance of iatrogenic injury of the nerval structure. The operation was uneventful. The present manuscript aims to highlight a scarce anatomic variation and its implications for thyroidectomy...
January 2018: Journal of Surgical Case Reports
A Machens, M Elwerr, K Lorenz, F Weber, H Dralle
BACKGROUND: A comprehensive assessment has not been undertaken of long-term outcomes in children carrying germline RET mutations and undergoing prophylactic thyroidectomy with the aim of preventing medullary thyroid cancer (MTC). METHODS: A retrospective outcome study (1994-2017) of prophylactic thyroidectomy in children, with and without central node dissection, was performed at a tertiary surgical centre. RESULTS: Some 167 children underwent prophylactic thyroidectomy, 109 without and 58 with concomitant central node dissection...
January 2018: British Journal of Surgery
I-Cheng Lu, Pi-Ying Chang, Gregory W Randolph, Hsiu-Ya Chen, Kuang-Yi Tseng, Yi-Chu Lin, Feng-Yu Chiang, Che-Wei Wu
OBJECTIVES: During monitored thyroidectomy, displacement of the recurrent laryngeal nerve (RLN) or vagus nerve (VN) in some complicated cases can increase the risk of injury. Although increasing the stimulus current can facilitate nerve mapping and localization, the safety of a high-current stimulus remains unknown. Therefore, this study evaluated the safety of a high-current stimulus in a porcine model. METHODS: Short-duration (1 minute), high-current (3, 5, 10, 15, 20, 25, and 30 mA at 4Hz) stimulus pulses were repeatedly applied to the RLN or VN in six anesthetized piglets...
January 13, 2018: Laryngoscope
Özer Makay
Benign goiter is the most common endocrine disease that requires surgery, especially in endemic areas suffering from iodine-deficiency. Recent European and American guidelines recommended total thyroidectomy for the surgical treatment of multinodular goiter. Total thyroidectomy has now become the technique of choice and is widely considered the most reliable approach in preventing recurrence. Nevertheless, total thyroidectomy carries a substantial risk in terms of hypoparathyroidism and the morbidity associated with injury to the inferior laryngeal nerve...
December 2017: Gland Surgery
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
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
Roostam Kholmatov, Obinwanne Emejulu, Fadi Murad, Rizwan Aslam, Emad Kandil
Papillary thyroid cancer (PTC) rarely metastasizes to the retropharyngeal lymph nodes. Managing patients with locally advanced primary PTC and metastasis located in distant anatomical areas is challenging. Herein, we report a 56-year-old patient with locally advanced asymptomatic PTC, who presented with obstructive airway symptoms due to the metastatic retropharyngeal lymph node. The patient underwent simultaneous total thyroidectomy, central lymph node dissection, en bloc resection of strap muscle and left laryngeal nerve via cervical approach and transoral resection of the metastatic retropharyngeal lymph node...
December 2017: Gland Surgery
Vaninder K Dhillon, Ralph P Tufano
No abstract text is available yet for this article.
December 2017: Gland Surgery
Riju R Menon, Sreedutt Murali, C Gopalakrishnan Nair, Misha J C Babu, Pradeep Jacob
Introductíon: Goiter is a very common problem dealt with by surgeons. Surgical treatment of thyroid requires removal of a part (hemi) or whole of the gland (total thyroidectomy). The external branch of the superior laryngeal nerve (EBSLN) is an important but less researched structure to be preserved during surgery. Various studies have described the incidence of different types of EBSLN, but have not described regarding the relationship between the change in volume of the gland to the nerve...
November 2017: Indian Journal of Endocrinology and Metabolism
Xiaoyang Hua, Henry Diggelmann, Vishram Jalukar, Joseph W Turek, Nitin A Pagedar
BACKGROUND: Left nonrecurrent laryngeal nerve (LNRLN) is an extremely rare anatomic variant. The development of such anatomic variation requires the regression of both the fourth (aortic arch) and sixth (ductus arteriosus, DA) arches on the left side. Preoperative prediction of this variant is difficult but might reduce risk of nerve injury. METHODS: A 34-year-old female was indicated for thyroidectomy for a 2.4 cm follicular neoplasm and Graves' disease. Due to a positive medical history of 22q11...
February 2018: Annals of Otology, Rhinology, and Laryngology
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