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laryngeal nerve thyroidectomy

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https://www.readbyqxmd.com/read/29330874/safety-of-high-current-stimulation-for-intermittent-intraoperative-neural-monitoring-in-thyroid-surgery-a-porcine-model
#1
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
https://www.readbyqxmd.com/read/29322022/less-than-total-thyroidectomy-for-goiter-when-and-how
#2
REVIEW
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
https://www.readbyqxmd.com/read/29303067/modified-tumescent-solution-for-creating-working-space-during-endoscopic-thyroidectomy
#3
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
#4
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/29302493/locally-advanced-asymptomatic-papillary-thyroid-cancer-presenting-with-retropharyngeal-lymph-node-metastasis-symptoms
#5
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
https://www.readbyqxmd.com/read/29302475/the-pros-and-cons-to-real-time-nerve-monitoring-during-recurrent-laryngeal-nerve-dissection-an-analysis-of-the-data-from-a-series-of-thyroidectomy-patients
#6
EDITORIAL
Vaninder K Dhillon, Ralph P Tufano
No abstract text is available yet for this article.
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29285446/correlation-between-the-cernea-classification-of-external-branch-of-superior-laryngeal-nerve-in-relation-to-the-ultrasound-based-volume-of-thyroid-gland
#7
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
https://www.readbyqxmd.com/read/29199443/successful-prediction-of-a-left-nonrecurrent-laryngeal-nerve-in-a-patient-with-right-sided-aorta-and-aberrant-left-subclavian-artery
#8
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...
December 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/29188293/variation-of-thyroidectomy-specific-outcomes-among-hospitals-and-their-association-with-risk-adjustment-and-hospital-performance
#9
Jason B Liu, Julie A Sosa, Raymon H Grogan, Yaoming Liu, Mark E Cohen, Clifford Y Ko, Bruce L Hall
Importance: Current surgical quality metrics might be insufficient to fully judge the quality of certain operations because they are not procedure specific. Hypocalcemia, recurrent laryngeal nerve (RLN) injury, and hematoma are considered to be the most relevant outcomes to measure after thyroidectomy. Whether these outcomes can be used as hospital quality metrics is unknown. Objectives: To evaluate whether thyroidectomy-specific outcomes vary among hospitals, whether the addition of thyroidectomy-specific variables affects risk adjustment, and whether differences in hospital performance are associated with thyroidectomy-specific care processes...
November 29, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29162343/long-term-voice-quality-outcomes-after-total-thyroidectomy-a-prospective-multicenter-study
#10
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/29161172/development-of-an-attachable-endoscopic-nerve-stimulator-for-intraoperative-neuromonitoring-during-endoscopic-or-robotic-thyroidectomy
#11
Eui-Suk Sung, Jin-Choon Lee, Seok Hyun Kim, Sung-Chan Shin, Da-Woon Jung, Byung-Joo Lee
We developed a simple attachable endoscopic nerve stimulator that can be connected to monopolar cauterization surgical instruments. This study on porcine models aimed to investigate the feasibility and efficacy of an attachable endoscopic nerve stimulator for intraoperative neuromonitoring (IONM) before application in humans. We evaluated the electromyography (EMG) amplitudes of 8 recurrent laryngeal nerves in 4 pigs with a conventional nerve probe and the attachable endoscopic nerve stimulator. The attachable endoscopic nerve stimulator was feasible and safe in all cases...
November 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29142841/speech-therapy-after-thyroidectomy
#12
REVIEW
Wing-Hei Viola Yu, Che-Wei Wu
Common complaints of patients who have received thyroidectomy include dysphonia (voice dysfunction) and dysphagia (difficulty swallowing). One cause of these surgical outcomes is recurrent laryngeal nerve paralysis. Many studies have discussed the effectiveness of speech therapy (e.g., voice therapy and dysphagia therapy) for improving dysphonia and dysphagia, but not specifically in patients who have received thyroidectomy. Therefore, the aim of this paper was to discuss issues regarding speech therapy such as voice therapy and dysphagia for patients after thyroidectomy...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142834/two-stage-thyroidectomy-in-the-era-of-intraoperative-neuromonitoring
#13
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/29136734/-functional-recovery-after-recurrent-laryngeal-nerve-injury-on-different-electromyography-thresholds-during-thyroid-surgery
#14
X L Liu, C L Li, Y S Zhao, H Sun
Objective: To discuss the functional recovery after recurrent laryngeal nerve injury (RLNI) on different electromyography thresholds during thyroid surgery. Methods: The prospective experimentally were induced in 12 acute recurrent laryngeal traction animals (porcine) from December 2014 to December 2015, the amplitude and latency of electromyography, even time course during RLNI and recovery of 24 recurrent laryngeal nerves(RLN) were continuous intraoperative neuromonitoring(IONM), including 12 RLN releasing traction after 50% amplitude decrease (AD) and other 12 RLN after 70% AD...
November 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
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
#15
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/29120517/outpatient-versus-inpatient-thyroidectomy-a-systematic-review-and-meta-analysis
#16
REVIEW
Daniel J Lee, Christopher J Chin, Chris J Hong, Stefan Perera, Ian J Witterick
BACKGROUND: Outpatient thyroidectomy has gained popularity due to improved resource utilization. METHODS: We conducted a systematic review and meta-analysis using MEDLINE, EMBASE, CINAHL, Web of Science, and the Cochrane library. We included all studies examining the outcomes of outpatient thyroidectomy as compared with those of inpatient thyroidectomy. Risk of bias was assessed using the Newcastle-Ottawa scale. Postoperative complications (hematoma, hypocalcemia, and recurrent laryngeal nerve injury) and readmission/reintervention rates were compared...
January 2018: Head & Neck
https://www.readbyqxmd.com/read/29119329/a-functional-assessment-of-anatomical-variants-of-the-recurrent-laryngeal-nerve-during-thyroidectomies-using-neuromonitoring
#17
Beata Wojtczak, Krzysztof Kaliszewski, Krzysztof Sutkowski, Marek Bolanowski, Marcin Barczyński
PURPOSE: The aim of the study was to assess the usefulness of intraoperative neuromonitoring (IONM) in identifying anatomical variants of the recurrent laryngeal nerve (RLN) during thyroidectomies, with emphasis on the nerve's relationship to the inferior thyroid artery (ITA), Zuckerkandl's tubercle, nonrecurrent laryngeal nerves (NRLNs), and extralaryngeal bifurcation. METHODS: A total of 128 subjects undergoing surgery for thyroid disorders were enrolled in the study, and the course and anatomical variants of RLN were assessed with IONM application...
November 8, 2017: Endocrine
https://www.readbyqxmd.com/read/29114900/standing-thyroidectomy-in-10-horses
#18
Marco Marcatili, Sarah J Voss, Patrick J Pollock
OBJECTIVE: To describe a surgical technique for thyroidectomy in horses with thyroid neoplasia under standing sedation and local anesthesia. STUDY DESIGN: Retrospective study. ANIMALS: Client-owned horses (n = 10). METHODS: Medical records of horses with a history of thyroid enlargement were included in the study if thyroid gland enlargement was treated surgically via hemi- or bilateral thyroidectomy, with the horse standing and sedated...
November 8, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29110159/measuring-decision-making-during-thyroidectomy-validity-evidence-for-a-web-based-assessment-tool
#19
Amin Madani, Jordan Gornitsky, Yusuke Watanabe, Cassandre Benay, Maria S Altieri, Philip H Pucher, Roger Tabah, Elliot J Mitmaker
BACKGROUND: Errors in judgment during thyroidectomy can lead to recurrent laryngeal nerve injury and other complications. Despite the strong link between patient outcomes and intraoperative decision-making, methods to evaluate these complex skills are lacking. The purpose of this study was to develop objective metrics to evaluate advanced cognitive skills during thyroidectomy and to obtain validity evidence for them. METHODS: An interactive online learning platform was developed ( www...
November 6, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29110082/continuous-monitoring-of-the-recurrent-laryngeal-nerve
#20
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
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